HX64127176 
RC435.SH  1908     Psychopathological  r 


[LLIAM   DUNCAN   McKIM 

GRADUATE  OF 
COLUMBIA  UNIVERSITY 
B.,  1875;  A.  II.,  1878;  M.  D.,  1878 


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PSYCHOPATHOLOGICAL 
RESEARCHES 

STUDIES  IN  MENTAL  DISSOCIATION 

WITH  TEXT  FIGURES  AND  TEN  PLATES 


BORIS  SIDIS,  M.A.,  Ph.D.,  M.D. 

DIRECTOR    OF    THE    PSYCHOPATHOLOGICAL    LABORATORY 


BOSTON 
RICHARD  G.  BADGER 

QTtir  &orf)am  JDrcss 
1908 


Copyright  1902-1908,  by  Boris  Sidu 


All  Rights  Reserved 


PSYCHOPATHOLOGICAL   RESEARCHES 


CONTENTS 


Introduction 


Some  General  Remarks  Concerning 
Psychopathological  Research 

By  BORIS  SIDIS 
Chap.     I. — The  Principle  of  Reduction  i 

II. — The  Methods  of  Psychology  and  Psycho- 
pathology  .......         6 

III. — Psychosis  and  Introspection        ...       13 

IV. — The  Subjective  Method  and  its  Difficulties,     i  9 

V. — The  Artefacts  of  Psychopathology  .         .       25 

Mental  Dissociation  in  Functional  Psychosis 

By  BORIS  SIDIS 

and 

WILLIAM  A.  WHITE,  M.D., 

First  Assistant  Physician,  Binghamptoti  State  Hospital 

Chap.         I. — The    Patient's    History    and    Examina- 
tion          33 

II. — Examination  of  the  Subconscious  .       41 

III. — Experiments    on    the    Intelligence    of 

Dissociated  Subconscious  Systems     .       49 

IV. — Subconscious  Reactions    ....      55 

V. — Subconscious  Experiences        ...       60 

VI. — Subconscious  Motor  Manifestations     .       65 


vi  Contents 

PAGE 

VII. — The  Psychopathic  Paradox     ...       68 

VIII. — Memory  and  Intelligence  of  the  Sub- 
conscious         72 

IX. — Subconscious  Habit  Formation       .        .       76 

X. — Subconscious      Retention  —  Automatic 

Writing  and  Anaesthesia    ...       83 

XI. — Suggestibility  in  the  Waking  State     .       87 

XII. — Synthesis   of    Dissociated    Subconscious 

Systems  .......       90 

Mental  Dissociation  in  Alcoholic  Amnesia 

By  WILLIAM  A.  WHITE 

Chap.    I. — Amnesia  and  Hypnoidal  States           .         .     103 
II. — The  Lapsed  Periods 113 

Mental  Dissociation  in  Psychic  Epilepsy 

By  WILLIAM  A.  WHITE 

Introduction     .  .  ,  .         .         .         .         .     123 

Chap.      I. — Anamnesis  and  Psychophysical  Examina- 
tion     125 

II. — Origin  and  Growth  of  Dissociation        .     132 

III. — The     Development     of     the     Secondary 

State 147 

IV. — The  Synthesis  of  the  Dissociated  States,      153 

Mental  Dissociation  in  Depressive  Delusional 
States 

By  BORIS  SIDIS 

Chap.         I. — The  History  and  the  Formed  Delusion     159 


Contents  vii 

PAGE 

II. — A  Review  of  the  General  Psychomotor 

States 164 

III. — The    Phenomena    of    Affective    Triple 

Personality 170 

IV. — The  Psychogenetic  Law  .         .         .         .177 

V. — The    Power    of     Assimilation    of     the 

Dominant  System  .         .         .         .185 

VI. — The  Predominance  of  Motor  Psychosis,     192 

VII. — Subconscious    Disintegration    and    the 

Affective  Personalities      .         .         .     203 

VIII. — Dynamogenesis    and    Disintegration   of 

the  Dominant  System  .         .         .     209 

IX. — Re-emergence  of  Disintegrated  Groups 

and  their  Final  Dissolution     .         .217 

Mental  Dissociation  in  Depressive 
Delusional  States 

Experimental  Data 220 

By  BORIS  SIDIS 

and 

GEORGE  M.  PARKER,  M.D., 

Assistant  in  Psychopathology,  Psychopathological  Laboratory. 

Mental  Dissociation  in  Functional  Motor 
Disturbances 

By  GEORGE  M.  PARKER 

Chap.     I. — History  and  Examination  ....     255 

II. — The  Psychic  Trauma  ....     261 

III. — Dissociation  and  Synthesis         .        .        .     274 


viii  Contents 

PAGE 

Mental  Dissociation  in  Psychomotor  Epilepsy 
By  GEORGE  M.   PARKER 

Chap.      I. — Psychomotor  Manifestations      .         .         .  280 

II. — First  Attacks  and  Aura    ....  284 

III. — Submerged  Experiences  of  Lapsed  Periods  290 

IV. — Lapsed  Periods  and  Hypnoidal  States    .  302 

V. — Hypnoidal  States  and  Synthesis      .         .  312 

Index 321 


Plates  I  to  X 


INTRODUCTION 

The  present  researches  form  a  series  of  cases  the 
investigation  of  which  is  undertaken  with  the  object 
of  studying  the  problems  presented  by  the  phenomena 
of  functional  psychosis.  Out  of  a  mass  of  material 
we  have  selected  a  few  cases  typical  of  many  others, 
each  case  standing  for  a  type.  As  much  as  possible 
we  have  tried  to  avoid  theories  and  principles  and 
give  simply  a  resume  of  the  facts  and  experiments. 
The  more  general  aspects  of  these  cases  and  the 
conclusions  flowing  from  similar  observations  and  ex- 
periments are  relegated  to  another  work  soon  to  ap- 
pear under  the  title  of  Principles  of  Psychology  and 
Psychopathology.  The  cases  are  more  in  the  nature 
of  laboratory  researches,  each  case  standing  on  its 
own  individual  merits ;  they  are  all,  however,  inti- 
mately interconnected,  representing  various  phases 
and  stages  of  the  processes  of  mental  dissociation. 

The  methods  of  work  of  this  series,  as  well  as  of 
the  series  to  come,  have  all  of  them  been  developed 
in  the  psychopathological  laboratory, — the  researches 
being  carried  on  in  the  laboratory  or  at  other  places 
under  its  direction. 


x  Introduction 

The  first  study  of  the  series  presents  an  investiga- 
tion of  the  main  phenomena  observed  in  dissociative 
states  of  functional  psychosis.  An  account  is  given 
of  some  of  the  methods  of  bringing  about  a  synthe- 
sis of  subconscious  dissociated  systems.  The  study 
specially  relates  to  psychomotor  reactions  of  sub- 
conscious systems.  Different  methods  are  worked 
out  to  obtain  subconscious  reactions  to  stimulations. 
The  extent  and  intelligence  of  the  dissociated  sub- 
conscious systems  are  tapped  in  various  ways.  The 
results  clearly  reveal  the  nature  of  the  phenomena  of 
functional  psychosis.  Psychologically,  functional  psy- 
chosis is  coextensive  with  the  whole  domain  of  the 
subconscious.  Physiologically,  functional  psychosis  is 
correlated  not  with  organic  neuron  degeneration,  but 
with  functional  disaggregation  of  whole  systems  of 
neuron-aggregates.  In  functional  psychosis,  the  func- 
tion apparently  lost  and  destroyed  is  found  to  be 
present  in  the  subconscious, — the  loss  of  function  is 
purely  dissociative.  The  activity  is  preserved  and 
the  system  is  really  unaffected, — it  is  only  dissociated 
from  other  functioning  systems. 

If  the  psychomotor  manifestations  of  the  patho- 
logical process  of  neuron  disaggregation  and  neuron  de- 
generation be  formed  into  a  series,  then  the  first  stages 
of  this  process  constitute  the  phenomena  of  functional 
psychosis  concomitant  with  the  pathological  conditions 
in  which  only  the  associations,  the  interrelations  of 
neuron    systems   are   affected    by    dissociation, — the 


Introduction  xi 

neurons,  the  dissociated  aggregates  themselves  re- 
main unaffected.  The  whole  domain  of  the  subcon- 
scious belongs  to  these  stages  of  disaggregation  in 
the  course  of  the  pathological  process,  such  as  the 
phenomena  of  hypnosis,  of  somnambulism,  of  motor 
and  sensory  automatisms,  of  the  so-called  "  hysterical  " 
sensori-motor  disturbances  of  various  organs,  the 
functions  of  which  are  found  on  examination  in  the 
regions  of  the  subconscious  over  which  the  personal 
consciousness  has  lost  control  by  reason  of  neuron 
disaggregation  or  dissociation.  Here  belong  the 
phenomena  of  double  and  multiple  conciousness, 
the  various  forms  of  amnesias,  the  lost  content  of 
which  can  be  revealed  in  the  strata  of  subconscious 
life.  The  domain  of  functional  psychosis  also  in- 
cludes the  phenomena  of  the  different  forms  of  so- 
called  "  psychic  epilepsy."  Here  also  belongs  the 
great  class  of  psychomotor  manifestations  known  as 
"  degeneracies,"  such  as  the  phobias,  impulsions,  ob- 
sessions, fixed  ideas,  and  a  still  greater  class  of  psychic 
derangements, — a  class  that  opens  to  the  psycho- 
pathologist  almost  an  infinite  vista  for  investigation, 
namely,  the  functional  insanities,  forms  of  functional 
psychosis  which  simulate  and  apparently  closely  re- 
produce different  types  of  insanity. 

With  the  further  progress  of  the  pathological 
process  the  neuron  itself  becomes  affected.  In  the 
early  stages  of  the  process  of  neuron  degeneration, 
the     function    of    the     neuron     is     interfered    with, 


xii  Introduction 

although  restitution  is  still  possible.  These  stages 
include  the  vast  domain  of  functional  neuropathic 
disturbances,  such  as  paralysis  agitans,  choreas, 
idiopathic  epilepsy,  and  the  neuropathic  insanities, 
such  as  the  various  neuropathic  forms  of  manias  and 
melancholias,  of  periodical  and  circular  insanities,  of 
dementia  prsecox,  of  paranoias,  and  so  on. 

Finally,  in  the  last  stages  of  the  process  of  degen- 
eration, the  neuron  is  destroyed  and  restitution  is  no 
longer  possible.  Tabes,  general  paresis,  syringomy- 
elia, the  chronic  insanities,  amyotrophic  lateral  sclero- 
sis, acute  ascending  paralysis,  multiple  sclerosis, 
secondary  dementia — that  sad  terminus  of  the  chronic 
insanities, — and  many  other  nervous  and  mental  affec- 
tions in  which  the  body  cell  of  the  neuron — cytoplasm 
and  nucleus — has  become  destroyed,  all  belong  to  the 
last  stages  of  the  pathological  process  of  neuron 
degeneration,  stages  which  for  lack  of  a  better  name 
may  be  termed  necrotic  neuropathies.  The  whole 
pathological  process,  with  its  stages  and  concomitant 
psychomotor  manifestations,  may  thus  be  conveniently 
subdivided  into  three  great  classes,  one  passing  into 
the  other  by  imperceptible  degrees  :  functional  psycho- 
sis, functional  neuropathy,  and  7iecrotic  neuropathy. 

At  the  same  time,  as  already  pointed  out  in  a  former 
study,  the  important  fact  must  be  kept  clearly  in  view 
that  various  groups  and  systems  of  neurons  may  reach 
different  degrees  of  disaggregation  and  degeneration, 
may  be  simultaneously  in  different  stages  of  the  one 


Introduction  xiii 

continuous  descending  pathological  process.  Com- 
munities, clusters,  or  constellations  of  neuron-aggre- 
gates may  be  in  the  upper  levels  of  the  psychopathic 
state,  in  the  first  stages  of  functional  psychosis  ; 
others  in  the  deeper  levels  or  further  stages  of  the 
same  state  ;  others  may  be  in  various  stages  of  the 
functional  neuropathic  state ;  while  still  others  may  have 
reached  the  last  stages  of  the  necrotic  neuropathic 
conditions.  The  fact  that  various  systems  of  neurons 
are  often  in  different  stages  of  disaggregation  or  de- 
generation frequently  gives  rise  to  a  mixed  and  com- 
plex symptomatology,  the  malady  presenting  psycho- 
motor manifestations  belonging  to  different  stages  of 
the  descending  pathological  process.  The  psycho- 
motor manifestations  may  thus  vary  endlessly,  like 
colors  in  the  kaleidoscope.  From  this  standpoint  it 
may  be  said  that  the  symptomatic  side  of  disease, 
the  total  psychomotor  aspect  of  the  pathological  process, 
is  a  function  of  location,  7iumber,  and  degree  of  disso- 
ciation or  degeneration.  The  total  complex  of  psycho- 
motor ma?iifestatio?is  depends  on  the  location  and, 
number  of  neuron-aggregates  involved  and  on  the  stage 
or  degree  of  the  pathological  process  of  disaggregation, 
dissociation,  or  degeneration.  In  other  words  the 
psychomotor  manifestations  depend  on  three  main 
factors:  location,  number  of  neuron  aggregates,  or 
quantity  of  functioning  neuron  energy,  depth  of  level 
descended,  or  intensity  of  the  process  of  neuron  en- 
ergy liberation  ;  and  also  on  a  fourth  factor,  which 


xiv  Introduction 

may  be  regarded  as  secondary,  namely,  dissociation, 
whether  this  dissociation  takes  place  among  the  neuron 
systems  in  the  early  stages,  or  in  the  parenchyma  of  the 
neuron  in  the  later  stages  of  the  process  of  degeneration. 

Now  once  the  neuropathic  stages  are  reached, 
whether  they  be  the  early  or  the  last  ones,  whether 
they  be  the  functional  neuropathies  or  the  necrotic 
neuropathies,  the  functions  of  the  affected  neu- 
ron-aggregates are  gone  and  lost,  temporarily  or 
permanently,  according  to  the  stages  of  the  process. 
In  any  of  the  neuropathic  stages  of  the  pathological 
process  the  disturbed,  arrested,  or  lost  functions  are 
not  present  in  the  subconscious.  The  neuropathies, 
functional  and  necrotic,  are  essentially  organic  in 
character.  Unlike  functional  psychosis,  the  neuropa- 
thies have  no  subconscious  "  equivalents."  The 
functions  of  the  neuron-aggregates  that  have  entered 
the  neuropathic  stages  of  the  pathological  process 
of  neuron  degeneration  are  also  lost  subconsciously. 
Hence  in  the  neuropathies,  even  in  the  early  func- 
tional stages,  no  synthesis  is  possible,  because  no 
corresponding  subconscious  states  are  present.  The 
neitropathies  have  no  szibconsciousness. 

The  phenomena  of  functional  psychosis  form  the 
borderland  between  the  neuropathies  of  limited 
neuron-aggregate  degenerations  on  the  one  hand  and 
neuropathic  insanities  on  the  other.  Functional  psy- 
chosis is  the  common  ground  of  neurology  and  psy- 
chiatry.    The  joint  efforts  of  the  neurologist  and  the 


Introduction  xv 

psychiatrist,  directed  towards  a  thorough  investigation 
of  these  phenomena,  will,  no  doubt,  shed  additional 
light  both  on  psychiatry  and  neurology,  and  will  help 
to  open  up  an  important  domain  of  psychomotor 
manifestations  apparently  of  obscure  origin,  but  which 
the  weight  of  facts  and  the  whole  trend  of  psycho- 
pathological  research  seem  clearly  to  refer  to  definite 
conditions  of  dissociated  mental  systems  with  con- 
comitant disaggregation  of  neuron-aggregates. 

The  psychiatrist  who  deals  with  highly  complex 
phenomena  of  neuron  degeneration,  such  as  the  dif- 
ferent forms  of  mental  alienation,  will,  from  a  study 
of  functional  psychosis,  get  a  deeper  insight  into 
neuropathic  psychosis.  From  a  practical  therapeutic 
standpoint,  a  thorough  knowledge  of  functional  psy- 
chosis means  also  the  possibility  of  restitution,  of 
cure.  Both  from  a  theoretical  and  practical  point  of 
view,  the  psychiatrist  should  lay  special  stress  on 
the  study  and  investigation  of  functional  psychosis 
in  general  and  of  functional  insanity  in  particular. 
Fttnctional  psychosis,  fmictional  insanities,  should  be- 
come a  special  research  field  of  the  psychopathologist. 
Functional  psychosis  is  specially  characterized  by 
psychophysiological  disaggregation  where  synthesis  is 
still  possible.  The  only  way  of  restoring  the  disturbed 
equilibrium  is  to  bring  about  a  synthesis  of  the  dis- 
aggregated groups  with  the  functioning  systems  of 
the  upper  active  personality.  Such  a  synthesis  is  here 
brought  about  by  the  method  of  intermediary  states. 


xvi  Introduction 

This  method  was  utilized  with  great  success  in  other 
cases  presenting  phenomena  of  functional  psychosis. 
The  subconscious  psychomotor  reactions  and  the 
process  of  synthesis  of  disaggregated  systems  are 
certainly  not  unimportant  subjects  in  the  domain  of 
psychopathology. 

The  second  study,  that  of  alcoholic  amnesia,  deals 
with  the  bringing  out  of  subconscious  memories. 
Mental  experiences  of  a  moment-consciousness,  how- 
ever low  and  degenerate,  are  not  lost,  but  present  in 
the  subconscious  in  a  diffused  dissociated  form  and 
can  be  brought  out  in  hypnoidal  states  induced  by  the 
method  of  hypnoidization.  The  patient  is  practically 
in  his  waking  state  and  the  subconscious  memories 
surge  up  in  fragments.  The  study  at  the  same  time 
tends  to  show  that  amnesia  in  general,  and  alcoholic 
amnesia  in  particular,  does  not  necessarily  imply  a 
state  of  unconsciousness. 

The  study  coming  next  in  order  traces  the  growth 
and  development  of  a  persistent  dissociated  subcon- 
scious system  and  the  disturbances  brought  about  by 
its  periodic  eruptions  into  the  upper  strata  of  mental 
life.  The  case  with  its  psychic  manifestations  would 
have  ordinarily  been  classified  under  the  term  of 
"  psychic  epilepsy."  This  term,  though  ambiguous, 
may  be  accepted,  if  understood  not  in  the  sense  of 
epileptic  origin  or,  as  it  is  put,  "  psychic  equivalent  "  of 
epilepsy,  but  as  epileptoid  disturbances  of  a  purely 
mental  character  due  to  dissociative  states  of  func- 


Introduction  xvii 

tional  neuropsychosis  ;  in  the  same  way  as,  for  in- 
stance, psychic  anaesthesias  of  functional  diseases  are 
not  equivalents  of  organic  neuron  degenerations. 
Functional  psychosis  often  simulates,  mimics  closely 
forms  of  diseases  of  purely  organic  nature.  It  may 
be  said  that  in  the  pathological  world  one  meets  with 
manifestations  somewhat  akin  to  the  phenomena  of 
mimicry  observed  in  the  biological  world,  such,  for 
instance,  as  the  mimicry  of  colored  markings  found 
among  the  different  species  of  Lepidoptera  which,  ac- 
cording to  Darwin,  belong  not  only  to  distinct  gen- 
era, but  also  to  distinct  families.  The  phenomena  of 
"psychic"  epilepsy  are  of  the  nahire  of  post-hypnotic 
automatisms.  This  point  of  view  is  corroborated  by 
extensive  researches  in  other  cases  which  will  appear 
shortly  in  the  series.  From  a  theoretical  standpoint 
it  may  be  said  that  all  these  phenomena  under  in- 
vestigation are  the  manifestations  of  reproduction 
of  dissociated  moments-consciousness  of  the  desultory 
type.  The  various  types  of  moments-consciousness 
and  their  different  forms  of  reproduction  are  not 
discussed  here  ;  they  are  worked  out  in  detail  in  the 
Principles. 

The  fourth  study  consists  of  two  parts:  the  first1 
reviews  and  discusses  phenomena  of  mental  dissocia- 
tion in  an  interesting  case  of  depressive  delusional 
states ;  the  second  gives  experimental  data.  The 
main  interest  centres  round  the  formation  of  a  highly 

1  Read  in  extract  before  the  New  York  Neurological  Society,  May,  1902. 


xviii  Introduction 

organized  and  remarkably  stable  delusional  system 
with  its  characteristic  power  of  assimilation.  The  man- 
ifestations of  affective  personalities  and  the  process  of 
their  elimination,  fusion,  and  synthesis  as  well  as  their 
relation  to  the  dominant  delusional  system,  the  persis- 
tence of  the  dissociated  groups  and  their  insistent  recur- 
rence make  the  study  of  some  value  to  the  psychologist 
and  psychopathologist.  Finally,  the  course  of  dissolu- 
tion of  the  dominant  system  and  the  elimination  and 
fusion  of  the  affective  personalities  make  the  research 
interesting  not  only  from  a  theoretical,  but  also  from 
a  practical  standpoint. 

The  fifth  study  is  on  mental  dissociation  observed 
in  a  case  presenting  limited  psychomotor  disturb- 
ances. The  dissociated  subconscious  systems  may 
possess  as  content  some  moments  of  the  life  activity 
of  the  organism  as  a  whole  ;  in  that  case  the  state  of 
dissociation  may  give  rise  to  the  phenomena  of  so- 
called  "psychic"  epilepsy  of  the  sensory  or  of  the 
motor  type.  The  content,  however,  may  be  limited 
and  refer  only  to  the  activity  or  function  of  some 
particular  organ.  In  such  a  case  the  result  is  that 
the  central  functionally  affected  neuron  system  gives 
rise  to  more  or  less  profound  disturbances  in  the 
psychomotor  activity  of  the  special  organ.  Specific 
peripheral  sensori-motor  derangements — anaesthesia, 
paresthesia,  hyperesthesia,  hypoaesthesia,  paralysis, 
contractures,  convulsions  —  may  arise,  all  having 
the  distinct  features  of  functional  psychosis.      These 


Introduction  xix 

traits  of  functional  psychosis,  traced  under  many 
different  conditions  and  followed  through  various 
phases,  are  certainly  of  great  value  to  the  science  of 
abnormal  psychology. 

The  last  study,1  that  of  dissociated  states  in  psy- 
chomotor epilepsy,  deals  with  the  growth  and  de- 
velopment of  a  whole  system  presenting  psychomotor 
disturbances  apparently  of  an  epileptic  character. 
The  pyschomotor  manifestations  or  attacks  are 
traced  to  dissociated  mental  states.  The  attacks, 
however,  on  examination,  are  found  to  be  not  of  an 
epileptic  nature,  but  of  the  character  of  functional 
psychosis.  As  in  the  third  study,  the  phenomena 
prove  to  belong  to  the  type  of  "psychic"  epilepsy  in 
the  sense  of  epileptoid  manifestations  of  functional 
psychosis.  The  peculiarity  of  the  case  under  in- 
vestigation is  that  the  psychomotor  manifestations 
approach  closely  to  the  typical  psychomotor  de- 
rangements of  organic  epilepsy.  The  touchy  spot 
of  the  subconscious  system,  the  aura,  serving  as  the 
trigger  of  the  detached  system  characteristic  of  the 
reproduced  moment,  the  impulsive  form  and  vigor 
of  onset  of  the  psychomotor  manifestations,  all  present 
to  the  student  of  psychology  and  psychopathology 
many  points  of  interest.  Finally,  the  method  of 
bringing  the  buried  subconscious  memories  to  the 
foreground  of  consciousness,  the  progress  of  syn- 
thesis of  the  detached  systems  and  groups  and  the 

1  Read  before  the  American  Neurological  Association,  June,  1902. 


xx  Introduction 

greater  stability  of  that  synthesis  by  means  of  the 
method  of  hypnoidization,  forming  an  organic  union 
of  the  disaggregated  systems,  and  from  a  practical 
standpoint  resulting  in  the  disappearance  of  the  at- 
tacks, are  all  points  of  scientific  value  to  the  psycholo- 
gist and  psychopathologist.  These  points  are  all  the 
more  valuable  as  they  are  fully  corroborated  by  other 
investigations  and  cases  worked  on  parallel  lines  and 
on  similar  principles. 

Throughout  the  researches  the  processes  both  of 
disintegration  and  synthesis  are  followed  out.  Great 
stress  is  laid  on  reassociation,  or  synthesis  of  dissociated 
systems  and  groups  in  the  active  personal  consciotisness. 
The  processes  and  modes  of  synthesis  should  be  closely 
observed  and  experimented  upon,  because  they  often 
reveal  the  character  of  the  constituent  elements  of 
the  psychic  phenomena  under  investigation,  and  give 
an  insight  into  the  nature  of  the  synthetized  psychic 
compound.  The  psychologist  and  the  psychopath- 
ologist, like  the  physicist  and  the  chemist,  are  inter- 
ested not  only  in  the  processes  of  decomposition  and 
analysis,  but  also  in  those  of  recomposition  and 
synthesis.  Synthesis  verifies  analysis.  Moreover,  if 
the  psychologist  and  the  psychopathologist  are  inter- 
ested in  the  processes  of  synthesis  of  disintegrated  sys- 
tems from  a  purely  theoretical  standpoint,  the  physician 
and  the  psychiatrist  find  in  the  modes  and  processes  of 
synthesis  a  very  important  practical  aspect.  For  from 
a  therapeutic  standpoint  synthesis  is  cure. 


Introduction  xxi 

We  sincerely  hope  that  the  psychologist,  psycho- 
pathologist,  psychiatrist,  and  the  medical  man  of 
science  who  may  happen  to  be  interested  in  this  line 
of  research  will  realize  the  obstacles  and  difficulties 
encountered  in  the  investigations  of  psychopathic 
cases,  and  thus  come  to  realize  the  necessary  short- 
comings pertinent  to  the  very  nature  of  psycho- 
pathological  research  work. 

It  seems  to  us  fit  to  open  this  series  with  a  brief  dis- 
cussion concerning  the  difficulties,  methods,  and  nature 
of  psychopathological  research,  since  a  knowledge 
of  them  is  of  vital  importance  to  the  student  of 
psychopathology  in  general  and  to  that  of  psychiatry 
in  particular,  and  also  because  in  many  quarters  they 
have  given  rise  to  mistaken  notions  about  the 
phenomena  of  mental  life  and  to  fallacious  views 
regarding  the  nature  of  the  methods  employed  in 
psychopathological  investigations. 

We  wish  to  take  this  opportunity  to  make  our 
acknowledgments  to  the  former  Pathological  Institute 
of  the  New  York  State  Hospitals  founded  by  the 
first  President  of  the  New  York  State  Commission  in 
Lunacy,  Dr.  Carlos  F.  MacDonald,  where,  under  the 
liberal  conditions  provided  by  the  former  Director, 
Dr.  Ira  van  Gieson,  this  line  of  research  was  de- 
veloped, and  this  series  of  experiments  was  con- 
ducted. The  newly  appointed  head  of  the  State 
Commission  in  Lunacy,  in  his  destruction  of  the 
work    of    the    Pathological    Institute,    has    officially 


xxii  Introduction 

"  abolished  "  this  line  of  psychopathological  research. 
We  wish  here  to  express  our  gratitude  to  the  Trus- 
tees of  the  New  York  Infirmary  for  Women  and  Chil- 
dren, and  especially  to  Dr.  Alexander  Lambert,  for 
their  establishing  a  Psychopathic  Hospital  and  La- 
boratory where  this  line  of  research  is  continued,  and 
under  whose  auspices  this  series  is  published. 

Boris  Sidis. 

New  York,  1902. 


Some   General   Remarks   Concerning 
Psychopathological    Research 


By 

Boris  Sidis 


CHAPTER  I 

THE    PRINCIPLE    OF    REDUCTION 

The  entrance  to  the  province  of  psychopathology 
lies  through  the  domain  of  so-called  functional  psy- 
chosis. It  is  in  functional  psychosis  that  we  find  the 
initial  stages  of  the  more  advanced  states  of  mental 
degeneration.  This  necessity  of  investigating  first 
the  initial  stages  holds  true  in  the  experimental  sci- 
entific investigation  of  all  natural  phenomena.  When- 
ever we  want  to  determine  the  relations  and  laws  of 
certain  types  of  facts,  we  do  not  study  them  in  their 
manifestations  on  a  grand  scale.  To  grasp  the  laws 
of  phenomena,  the  latter  must  be  entirely  under  our 
control,  but  such  control  is  impossible  when  the  phe- 
nomena under  investigation  are  displayed  in  their  full 
force  and  grandeur.  We  do  not  study  electrical  phe- 
nomena in  the  lightnings  of  the  storm,  nor  do  we 


2  Psychopathological  Researches 

study  the  laws  regulating  the  tides  in  the  grand 
sweeping  waves  of  the  ocean.  The  laws  of  electricity 
would  never  have  been  discovered  had  we  been  con- 
fined to  the  direct  observation  of  electrical  storms, 
nor  would  the  laws  of  tides  ever  have  been  revealed 
in  the  observations  of  floods.  It  is  by  getting  hold 
of  similar  phenomena  reduced  to  a  more  insignificant 
state,  and  having  them  isolated,  getting  them  thus 
under  efficient  control,  ascertaining  the  conditions, 
and  having  them  manipulated,  changed,  modified,  and 
observing  the  effects — it  is  only  under  such  circum- 
stances that  the  nature  of  the  phenomena  can  be 
clearly  comprehended.  The  nature  and  laws  of  gal- 
vanism and  magnetism  become  revealed  in  the  feeble 
current  of  a  small  battery,  and  it  is  from  this  that  we 
gain  an  insight  into  the  nature  of  electrical  storms. 
The  electrical  spark  explains  the  lightning.  The 
majestic  sweep  of  the  awe-inspiring  billows  of  the 
ocean  is  replaced  in  the  laboratory  by  waves  pro- 
duced in  a  bowl  of  water.  The  aurora  borealis  is 
explained  by  the  glowing  of  the  cathode  ray  in  a  small 
glass  tube.  The  chemist  does  not  require  an  ocean 
to  find  out  the  constitution  of  water,  —  a  drop  of 
water  in  a  test  tube  is  all  that  is  requisite.  Com- 
bustion is  not  explained  in  the  great  fires  sweeping 
over  a  prairie, — a  candle  suffices.  Composition  of 
light  was  not  learned  from  the  observation  of  the 
rainbow,  but  on  the  contrary  the  rainbow  found  its 
explanation  in  the  refraction  phenomena  of  the  prism 


The  Principle  of  Reduction  3 

by  which  a  ray  of  white  light  is  decomposed.  An 
insight  into  the  nature  of  phenomena  is  given  by 
a  study  of  the  processes  on  a  reduced  scale  in  their 
feeble  initiatory  stages.  Universal  gravitation  and 
the  movements  of  solar  systems  are,  as  the  story 
runs,  learned  from  the  fall  of  an  apple.  The  scientist 
can  study  his  phenomena  only  when  they  are  on  a 
reduced  scale,  and  only  under  such  conditions  can  he 
handle  his  material  efficiently. 

In  the  study  of  the  nervous  system,  we  do  not  put 
a  whole  brain  under  a  microscope, — a  single  section, 
often  limited  to  but  a  few  isolated  neurons,  suffices.  In 
the  investigation  of  the  causes  and  laws  of  biology, 
we  do  not  carry  on  researches  on  elephants  or  hippo- 
potami,— amoebae,  cells  give  us  a  far  better  insight.  In 
geology,  the  formation  of  strata,  of  islands,  of  moun- 
tains and  continents  is  learned  from  the  actions  of 
rills,  brooks,  and  from  the  sediment  slowly  formed  in 
glasses  and  jars.  Great  effects  are  often  wrought  by 
the  persistent  action  of  small,  insignificant  causes..  The 
theories  of  grand  catastrophes  had  to  be  abandoned, 
and  the  slow  and  gradual  action  of  infinitely  small 
forces  recognized ;  these  alone  were  sufficient  to  re- 
veal the  mechanism  of  grand  and  complex  manifesta- 
tions. 

In  this  respect  the  very  theory  of  evolution  may 
serve  as  an  excellent  illustration.  The  pre-Darwinian 
biologist  worked  with  whole  species  and  genera,  and 
as  such  his  work  was  a  failure.      Darwin  started  with 


4  Psychopathological  Researches 

observations  and  experimentations  of  initial  stages  of 
insignificant  variations  produced  in  domestic  animals, 
especially  in  pigeons.  The  study  of  insignificantly 
small  differences  known  as  individual  variations  and 
divergencies  gave  him  a  deep  insight  into  the  origin 
of  species.  Modern  biology  goes  even  farther  into 
the  minutiae  of  cell  structure,  and  the  slightest 
differentia;  in  the  stages  of  cell  development  are 
followed  up  and  experimented  upon,  with  the  re- 
sult, that  the  insight  into  the  relations,  laws,  and 
conditions  of  biological  phenomena  becomes  wider 
and  deeper.  The  study  of  the  initial  stages  of  cell 
life  permits  the  biologist  to  get  for  the  first  time  a 
glimpse  into  the  great  problems  of  biological  science, 
those  of  heredity  and  variation.  It  is  in  the  seem- 
ingly insignificant  that  science  discovers  the  secrets  of 
the  most  potent  natural  forces  ;  it  is  in  the  apparently 
trivial  that  the  scientist  finds  the  key  to  the  deepest 
mysteries  of  nature. 

This  principle  of  reduction  is  all  the  more  important 
in  the  domain  of  abnormal  mental  life,  because  the 
phenomena  presented  to  the  investigator  are  of  ex- 
treme complexity.  Great  scientific  caution  must 
therefore  be  exercised  in  the  study  of  psychosis, 
and  only  the  strictest  application  of  the  principle 
of  reduction  can  help  us  to  gain  an  insight  into  the 
nature  and  laws  of  abnormal  mental  life.  Moreover 
he  who  deals  with  the  investigation  of  mental  phe- 
nomena, whether  normal  or  abnormal,  has  the  dis- 


The  Principle  of  Reduction  5 

advantage  that  his  material  cannot  be  directly 
modified  at  will  without  extreme  caution,  since  the 
factors  entering  into  the  problem  are  complex  and 
form  an  organic  whole  the  least  disturbance  of  which 
may  produce  permanent  injury  to  the  mental  or 
physical  constitution  of  the  organism. 


CHAPTER  II 

THE  METHODS   OF  PSYCHOLOGY   AND   PSYCHOPATHOLOGY 

The  investigator  of  mental  life  has  two  methods  of 
procedure,  one  more  of  an  external,  the  other  more 
of  an  internal  character.  Without  the  least  direct 
modification  in  the  psychophysiological  organization, 
one  may  study  the  effects  consequent  on  the  modifi- 
cation of  certain  conditions  of  the  external  environ- 
ment, changing  the  external  stimuli  and  their  incoming 
impressions.  This  method  is  of  an  indirect  character, 
inasmuch  as  it  does  not  directly  modify  the  material 
under  investigation.  In  endeavoring  to  find  the 
threshold  of  sensibility  to  touch  or  to  sound  stimuli, 
as  when  trying  to  discover  the  relation  of  apprecia- 
tion of  stimulations  to  their  objective  increase,  we  do 
not  in  the  least  change  the  sensitivity  itself — in  fact,  a 
change  in  sensitivity  would  destroy  the  object  of  the 
inquiry.  Sensitivity  is  left  alone,  unchanged ;  no 
anaesthesia,  no  hypoaesthesia,  no  hyperaesthesia  is  pro- 
duced. The  function  of  sensitivity  remaining  un- 
changed, we  may  find  that  within  certain  limits  in  the 
muscular  sense,  for  instance,  the  increase  of  a  weight 
stimulus  is  appreciated  with  the  increase  of  -^V  °f  lts 
magnitude  ;  that  in  strain  sensibility  such  as  the  ap- 


Psychology  and  Psychopathology     7 

preciation  of  lifted  weights  the  increase  required  is 
^l  ;  that  in  sound  it  is  -^  ;  that  in  vision  it  is  y^-,  and 
finally  we  may  arrive  at  Weber's  law  that  the  sub- 
jective appreciation  of  an  increase  in  an  external 
stimulus  is  brought  about  when  that  increase  bears  a 
constant  proportion  to  the  given  objective  stimulus ; 
or  one  may  generalize  further  with  Fechner  that 
sensation  varies  as  the  logarithm  of  the  stimulus. 
If  similarly  we  try  to  study  memory,  for  instance,  by 
the  external  method,  we  may  try  to  find  out  the 
span  of  memory  by  memorizing  in  a  given  time 
a  definite  series  of  words,  numbers,  or  so-called 
"  nonsense  "  syllables  ;  in  a  similar  way  we  may  study 
the  elements  of  time  in  the  lapses  of  memory — how 
much,  for  instance,  of  a  given  series  can  be  repeated 
after  a  certain  interval  of  time,  and  how  long  it  takes 
to  relearn  it.  The  function  of  recall  remaining  un- 
changed, one  may  experimentally  arrive  with  Ebbing- 
haus  and  Wolfe  at  the  general  law  that  the  quotients 
of  retention  and  forgetfulness  are  inversely  propor- 
tional to  the  logarithms  of  the  times  passed  since  the 
first  memorization.  Here  once  more  the  modifications 
effected  are  not  in  the  psychic  function  itself,  since 
the  function  of  remembering,  of  recall,  is  from  the 
very  nature  of  the  experiment  left  unchanged,  —  no 
amnesia,  no  hypomnesia,  no  paramnesia,  no  hyperm- 
nesia  is  produced.  In  other  words,  the  indirect 
external  method  leaves  the  psychic  functions  un- 
altered   and    modifies    only    the    conditions    of    the 


8  Psychopathological  Researches 

external  environment.  The  indirect  method  of  ex- 
ternal modification  is  adapted  to  the  study  of  the 
normal  psychic  function. 

In  our  researches  into  the  nature  and  laws  of 
psychic  life,  we  may  proceed  by  a  different  way, — we 
may  leave  the  external  conditions  unaltered  and  have 
the  modification  produced  in  the  psychic  function 
itself.  We  may  study  directly  the  function  of  sensi- 
tivity in  its  various  forms  by  producing  or  observing 
the  various  changes  and  modifications  occurring  in  the 
very  function  under  investigation.  We  may  study  how 
the  same  stimuli  work  on  a  sensibility  whose  threshold 
is  greatly  changed,  lowered,  raised,  or  altogether 
lost ;  in  other  words,  we  can  study  the  function  of 
sensibility  in  the  various  gradations  of  hypoaesthesia, 
hyperesthesia,  and  paresthesia.  The  changes  in  the 
function  of  sensibility  give  us  an  insight  into  the 
relations  of  sensations  and  the  modes  of  their  aggre- 
gations and  combinations.  .  The  modifications  or 
eliminations  of  definite  elements  of  visceral  sensi- 
bility give  us  an  insight  into  the  nature  of  emotions  and 
moods,  whether  in  normal  or  abnormal  states,  such 
as  are  found  in  the  different  forms  of  mental  aliena- 
tion,—mania,  melancholia,  periodical  and  circular 
insanity,  paranoia,  general  paresis,  etc.  Modifications 
of  the  external  senses,  such  as  touch,  vision,  audition, 
kinaesthesis,  etc.,  give  us  an  insight  into  perception, 
normal  or  fallacious,  such  as  the  perception  of  spatial 
relationships,    movement,    extension,    position,   local- 


Psychology  and  Psychopathology  9 

ization,  distance,  magnitude,  translocation,  etc.,  with 
their  numerous  illusions  and  hallucinations.  Modifi- 
cations in  the  function  of  presentation  and  represen- 
tation by  the  observation  and  induction  of  illusions 
and  hallucinations  furnish  an  explanation  to  the 
mode  of  change  and  combination  of  their  various 
constituent  psychic  elements  and  processes,  and  we 
may,  for  instance,  arrive  at  the  conclusion  that  hallu- 
cinations are  of  the  nature  of  secondary  sensations, 
— that  hallucinations  are  really  secondary  percepts. 
These  may  in  turn  unravel  the  nature  of  the  differ- 
ent forms  of  mental  aberrations  accompanied  by  illu- 
sions and  hallucinations  of  the  different  senses.  In  the 
mental  derangements  as  manifested  in  the  different 
forms  of  sensory  aphasia,  apraxia,  general  and  spe- 
cific amnesia  of  an  organic  character,  we  discover 
the  isolated  factors  that  enter  into  the  organic  tissue 
of  our  psychic  activity.  In  the  delusions  of  the  insane, 
in  the  psychomotor  manifestations  of  insistent  and 
fixed  ideas,  of  imperative  impulses  and  uncontrollable 
emotional  states,  we  find  a  mine  of  valuable  modifica- 
tions of  mental  functions  the  investigation  of  which 
gives  a  deep  insight  into  the  nature  of  mental  proces- 
ses. Finally,  in  the  phenomena  manifested  by  the 
infinite  number  of  variations  presented  by  functional 
psychic  derangements,  we  find  an  inexhaustible  wealth 
of  material  for  the  study  of  mental  life,  both  in  its 
normal  and  abnormal  phases.  Mental  functions 
known  under  the  collective  names  of  memory,  will, 


io  Psychopathological  Researches 

personality  in  its  various  aspects,  and  the  vast  domain 
of  the  subconscious  with  its  multifarious  manifesta- 
tions, open  an  infinite  vista  to  the  pioneer  inves- 
tigator. We  may,  for  instance,  find  the  relation  of 
suggestibility  to  the  suggestion-stimulus  ;  that  nor- 
mal suggestibility  varies  as  indirect  and  abnormal 
suggestibility  as  direct  suggestion.  The  phenom- 
ena of  psychopathic  anaesthesia,  aboulia,  amnesia, 
psychopathic  fixed  ideas,  recurrent  dissociated  mo- 
ments, multiple  personality  —  all  form  an  inexhaus- 
tible mine  for  the  study  of  the  laws  and  relations  of 
mental  processes  and  the  various  types  of  mental 
activity,  and  we  may  arrive  at  the  important  general- 
ization that  functional  psychosis  is  a  disaggregation 
of  psychophysiological  constellations,  a  dissociation 
of  moments-consciousness  accompanied  by  a  corre- 
sponding dissociation,  or  possibly  retraction,  of  neuron 
systems.  It  is  in  functional  psychic  manifestations 
that  the  principle  of  reduction  is  most  fully  exem- 
plified, since  they  present  the  initial  stages  of  psychic 
modifications,  and  hence  they  lend  themselves  best 
to  the  scientist  for  the  graining-  of  an  entrance  into 
the  regions  of  psychomotor  life. 

We  must  discriminate  between  two  methods — that 
of  observation  and  that  of  experimentation.  All  the 
cases  presenting  modifications  of  an  organic  character 
fall  chiefly  under  the  method  of  observation,  since 
their  production  is  not  in  our  control ;  they  are  taken 
as  given,  the  conditions  of  their  origin  and  develop- 


Psychology  and  Psychopathology    1 1 

ment  being  often  obscure  or  entirely  unknown.  These 
cases  are,  however,  subject  to  the  indirect  method  of 
investigation  of  external  stimulations,  the  altered 
mental  functions  remaining  further  unmodified,  thus 
giving  rise  to  a  new  norm  of  sensitivity.  Modifica- 
tions of  an  organic  character  are  also  subject  to  direct 
modification  by  means  of  physiological  stimulations, 
such,  for  instance,  as  are  brought  about  by  some 
toxic  stimuli,  and  they  are,  although  to  a  very  slight 
degree,  directly  modified  by  psychopathic  methods 
of  investigation.  Psychic  cases  presenting  organic 
degeneration  are  nature's  own  experiments  and  as 
such  they  are  of  extreme  value,  but  they  often  present 
advanced  stages  of  modification  where  the  changes 
are  too  great  and  intense.  The  gap  produced  by 
organic  degeneration  is  often  too  wide  to  be  directly 
of  full  service  to  the  investigator.  In  order,  there- 
fore, to  have  organic  cases  utilized  to  their  full  extent, 
the  only  way  is  to  find  cases  presenting  intermediary 
stages  of  modifications,  thus  filling  up  the  impassable 
gaps  in  the  series  of  the  process  of  degeneration.  It 
is  in  functional  psychic  derangements  that  one 
can  find  the  proper  material  for  investigation, — 
material  that  lends  itself  readily  for  control  and 
manipulation.  It  is  in  functional  psychic  diseases 
that  one  finds  the  initial  stages  of  psychomotor 
modifications,  and  it  is  here,  in  the  functional  psycho- 
pathic diseases,  that  the  principle  of  reduction  is  fully 
manifested, — the  psychomotor  phenomena  appear  on 


12  Psychopathological  Researches 

a  small  reduced  scale  manageable  and  controllable 
by  the  hand  of  the  experimenter.  That  is  why  the 
investigation  of  functional  psychopathic  changes  is 
so  important  in  the  unravelling  of  the  relations  and 
laws  that  obtain  among  the  phenomena  of  mental  life. 
This  line  of  research  is  all  the  more  valuable,  because 
in  the  artificial  subconscious  states  functional  psycho- 
pathic phenomena  can  be  reproduced  experimentally 
and  the  conditions  of  their  states  can  be  closely 
studied.  Functional  psychosis  is  therefore  of  the 
highest  moment  in  the  study  of  psychomotor  life 
phenomena. 


CHAPTER  III 

PSYCHOSIS    AND    INTROSPECTION 

If  from  a  general  scientific  standpoint  we  find  that 
we  can  penetrate  into  the  nature  of  psychosis  by- 
studying  the  initial  stages  of  mental  dissolution,  a 
closer  inspection  shows  that  there  is  a  special  reason 
why  this  procedure  is  absolutely  indispensable.  The 
phenomena  of  psychosis  are  not  of  the  same  nature 
as  physical  phenomena,  and  do  not  lend  themselves 
to  immediate  observation  and  still  less  to  direct  ma- 
nipulation and  experimentation.  Psychic  phenomena 
are  not  of  an  objective,  but  of  a  subjective  nature, 
and  as  such  must  be  largely  studied  by  subjective 
methods  of  investigation.  Sensations,  images,  ideas, 
thoughts,  judgments,  feelings,  emotions,  the  material 
of  the  sciences  dealing  with  mental  life,  can  not  be 
touched,  handled,  cut,  fixed,  stained,  and  inspected 
under  a  microscope.  An  idea,  a  feeling,  can  not  be 
measured  in  millimetres,  nor  weighed  in  scales,  nor 
dipped  into  a  fixing  fluid  for  further  reference.  Sensa- 
tions, feelings,  ideas,  and  emotions  do  not  admit  of 
being  touched,  seen,  smelled,  heard,  nor  tasted,  for  they 
have  no  physical  properties.  A  psychic  phenome- 
non has  no  resistance,  no  elasticity,  no  weight,  no 
extension,  nor  can  it  be  measured  by  lines,  squares,  and 

13 


14  Psychopathological  Researches 

cubes.  An  idea  does  not  sound,  nor  has  it  odor,  nor 
taste,  nor  is  it  black,  blue,  green,  red,  yellow,  or  violet. 
Being  of  a  subjective  character  psychic  phenomena 
require  subjective  methods  of  investigation,  those  of 
introspection.  Introspection  is  the  most  important 
instrument  of  psychological  research  ;  it  is  the  micro- 
scope of  the  psychologist  and  psychopathologist ; 
it  is  the  powerful  instrument  of  mental  analysis 
and  synthesis,  the  scalpel  and  microtome  for  psychic 
dissection  and  the  means  for  mental  fixation  and 
preservation.  We  can  know  of  what  is  going  on 
in  our  mind  by  our  own  introspection,  and  we  can 
find  out  what  is  going  on  in  other  people's  minds  by 
the  account  of  their  own  introspection,  or  by  what  is 
far  less  certain,  the  introspective  interpretation  of 
their  motor  manifestations.  In  no  other  way  can  we 
possibly  gain  access  to  mental  phenomena.  In  the 
study  of  perception,  conception,  and  memory,  in  the 
investigation  of  illusions,  hallucinations,  insistent 
concepts,  fixed  ideas,  imperative  and  recurrent  but 
repressed  impulses,  delusions  systematized  and  unsys- 
tematized, amnesia,  aphasias,  etc.,  on  what  else  do 
we  fall  back  ultimately  but  introspection,  the  main 
instrument  of  psychology  and  psychopathology  ?  If 
it  were  not  for  the  patient's  account  of  his  experi- 
ences ;  if  it  were  not  for  the  introspective  interpreta- 
tion of  his  various  actions  based  on  his  accounts, 
statements,  and  reactions,  what  could  we  possibly 
know  of  all  those  experiences  the  psychologists,  the 


Psychosis  and  Introspection  15 

psychopathologists,  the  psychiatrists  tell  us?     Intro- 
spection alone  can  reveal  a  psychic  fact. 

If  we  turn  to  those  branches  of  neurology  that  are 
concerned  with  psychic  processes,  we  find  the  same 
truth  illustrated — the  introspective  method  is  the  main 
guide  in  the  inquiry.  Neurological  investigations  of 
aphasia  are  really  based  on  the  introspective  method 
of  psychological  analysis.  The  percept  is  resolved 
into  its  psychic  constituents,  into  so-called  "  images," 
by  means  of  introspection  alone.  Take  the  stock 
example  of  the  "bell  images."  What  are  the  mental 
images  aroused  on  hearing  a  bell  ring,  on  seeing  a 
bell,  on  hearing  the  word  "  bell,"  on  pronouncing  or  on 
writing  the  word  "  bell  "  ?  Introspection  alone  can  give 
us  the  answer.  Sensations,  "  memory  images,"  repre- 
sentations can  not  possibly  be  measured  in  microns,  nor 
fixed  in  hardening  fluids  ;  they  are  essentially  psychic 
in  character,  gained  from  an  introspective  analysis. 
And  still  the  neurologist  does  not  hesitate  a  moment 
to  base  his  scientific  work  of  aphasia  on  such  introspec- 
tive accounts.  Whether  the  psychophysiological  asso- 
ciation theory  of  localized  "  images  "  accepted  by  the 
neurologist  is  right  or  wrong,  one  thing  is  sure  and 
clear  that  there  is  no  possibility,  even  for  people  with 
a  strong  objective  bent  in  their  investigations,  such  as 
presented  by  the  neurologist,  to  get  at  psychic  phe- 
nomena by  any  other  method  than  that  of  introspec- 
tion. How  else  can  a  psychic  fact  be  reached?  A 
psychic    fact    can    not    possibly    be    magnified    by    a 


1 6  Psychopathological  Researches 

microscope,  nor  dissolved  out  of  the  brain  by  means 
of  chemical  reagents,  nor  seen  by  the  light  of  a 
Roentgen  ray,  nor  revealed  by  the  aid  of  spectral 
analysis.  The  contents  of  a  psychic  state  can  be 
reached  through  introspection  alone. 

Turning  to  the  analysis  of  cases,  we  find  that  the 
neurologist  is  guided  by  the  patient's  introspective 
account  interpreted  in  the  light  of  the  general  psy- 
chological theory  maintained  by  the  neurologist  and 
gained  from  introspection.  The  patient  suffers  from 
visual  apraxia,  he  is  shown  a  bell  and  he  tells  us  that 
he  does  not  know  what  it  is,  but  he  does  recognize 
the  bell  when  it  is  rung  or  put  in  his  hand  ;  the  neu- 
rologist concludes  that  the  visual  memory-images  are 
lost.  How  does  the  neurologist  arrive  at  this  con- 
clusion if  not  by  the  method  of  introspection  ?  The 
patient  gives  us  to  the  best  of  his  abilities  what  the 
sensations  of  certain  forms,  size,  and  color  indicate 
to  him,  and  the  neurologist  further  interprets  this 
introspective  experience  as  to  what  the  psychic 
material  and  factors  are  for  the  complete  perception 
of  the  external  object.  The  patient  suffers  from 
auditory  aphasia,  he  can  hear  sounds  but  can  not 
understand  the  meaning  of  words.  The  patient  ex- 
periences the  components,  the  sounds,  and  syllables, 
but  does  not  realize  their  combinations  and  associa- 
tions. The  neurologist  concludes  that  the  patient's 
memory  for  auditory  word-images  is  lost  ;  although  in 
the  present  hypothetical  case  it  is  not  the  auditory- 


Psychosis  and  Introspection  17 

word-images  that  are  gone,  it  is  more  probable  that 
the  manifestations  are  due  to  dissociation  from  the 
memories  relating  to  the  other  senses..  Whatever 
the  real  psychological  interpretation  be,  one  thing 
stands  out  clear  and  distinct,  and  that  is  the  necessity 
of  falling  back  on  the  patient's  introspective  account 
of  his  experiences.  The  neurologist  further  in- 
terprets the  psychic  deficiency  by  his  own  introspec- 
tive analysis  as  to  what  sort  of  psychic  content  may 
be  absent  to  account  for  the  mental  symptoms,  and 
puts  them  down  to  the  failure  or  loss  of  auditory 
memory-images.  An  autopsy  may  reveal  the  fact  of 
degeneration  in  the  convolutions  of  the  temporal 
lobes,  and  the  neurologist  comes  to  regard  these 
convolutions  as  the  area  for  auditory  memory-images 
found  and  analyzed  introspectively.  Whether  the 
neurologist  is  right  or  wrong  in  his  generalization, 
the  method  of  procedure  and  the  conclusion  arrived 
at  are  essentially  of  an  introspective  character. 

Similarly  in  visual  aphasia,  such  as  alexia,  the 
patient  sees  words  but  does  not  know  how  to  read 
them  ;  the  patient  may  even  be  able  to  describe  the 
color,  size,  and  form  of  the  letters ;  he  may  be  able 
to  copy  and  even  write  spontaneously,  to  recall 
how  to  read  written  or  printed  characters.  The  neu- 
rologist may  point  out  the  missing  psychic  elements 
necessary  to  the  formation  of  the  comprehension  of 
written  or  printed  words,  and  refer  the  "  symptoms  " 
to  the  loss  of  visual  memory-word-images  ;  although 


1 8  Psychopathological  Researches 

here  again  it  may  be  more  correct  in  this  case  to  refer 
it  to  a  lesion,  or  dissociation,  organic  or  functional, 
between  certain  groups  of  visual  memories  and  those 
derived  from  other  sources.  An  autopsy  may  reveal 
a  lesion  or  degeneration  in  certain  portions  of  the 
convolutions  of  the  occipital  lobes,  and  the  neurologist 
arrives  at  the  generalization  that  the  convolutions 
of  the  occipital  areas  contain  "visual  centres."  By 
what  other  method  is  the  neurologist  guided  here 
if  not  by  that  of  introspection  ?  Introspection  is  the 
main  method  of  all  branches  of  psychological  sciences 
for  the  simple  reason  that  there  is  no  other  way  of 
gaining  access  to  psychic  phenomena.  Introspection 
alone  can  give  direct  cognizance  of  mental  facts. 

Psychological  introspection,  however,  must  by  no 
means  be  confused  with  the  introspection  of  the 
metaphysician.  The  introspective  method  of  psy- 
chology is  of  a  purely  scientific  character ;  it  simply 
deals  with  facts  of  consciousness,  such  as  sensations, 
percepts,  images,  ideas,  sentiments,  affections,  emo- 
tions, decisions  of  will ;  it  investigates  their  conditions, 
constitution,  and  laws.  Psychology,  in  short,  deals 
with  the  psychic  facts  and  their  relations.  Psychol- 
ogy uses  the  methods  of  observation  and  experiment ; 
it  starts  with  psychic  phenomena  and  does  not  leave 
the  ground  of  mental  life  ;  it  remains  entirely  subjec- 
tive throughout ;  psychological  findings,  laws,  and 
theories  are  concerning  mental  manifestations,  con- 
cerning facts,  facts  of  consciousness. 


CHAPTER  IV 

THE    SUBJECTIVE    METHOD    AND    ITS    DIFFICULTIES 

In  the  investigation  of  mental  life-processes,  the 
subject's  or  patient's  co-operation  is  of  the  utmost  im- 
portance ;  without  it  our  steps  are  uncertain  and  the 
conclusions  are  dubious  ;  in  fact,  nothing  whatever 
can  possibly  be  accomplished,  since  the  very  subject 
matter  of  investigation  is  lacking.  It  is  clear  then 
that  under  such  conditions  the  only  cases  truly  valu- 
able for  psychological  and  psychopathological  research 
are  those  which  have  not  travelled  far  on  the  road  of 
mental  dissolution,  because  they  alone  are  in  that 
stage  where  a  subjective  account  is  still  possible. 
Those  cases  of  mental  dissolution  that  have  ad- 
vanced far  on  the  way  of  disintegration  can  not  be 
utilized,  because  they  are  unable  to  give  directly  an 
account  of  their  experiences,  and  all  we  can  know  of 
them  must  simply  be  a  matter  of  guess  and  inference. 
The  cases  presenting  advanced  stages  of  mental  dis- 
solution can  only  be  understood  in  the  light  of  the 
initiatory  stages  ;  advancing  step  by  step  through  the 
transitional  and  intermediary  stages  of  dissociation 
and  disintegration.  Functional  psychosis  alone  com- 
plies with  all  such  conditions  and  supplies  ample  ma- 
terial for  scientific  experimental  research. 

19 


20  Psychopathological  Researches 

The  subjective  method  of  investigation,  required  by 
the  very  nature  of  psychic  phenomena,  makes  it  ex- 
tremely uncongenial  for  those  who  are  used  to  work 
objectively  with  the  rule,  the   scale,  the   microtome, 
and   the   microscope,  and  who    trust   to  their  senses 
alone,  relying  only  on  what  is  visible  and  tangible, 
taking  as  the  measure  of  reality  the  extensive  and  the 
ponderous,  all  else  being  in  their  opinion  so  much 
"  stuff  and  rubbish."     The  impartial  scientist,  however, 
will  without  hesitation  agree  that  sensations,  percep- 
tions, images,  ideas,  thoughts,  decisions  of  will,  judg- 
ments, beliefs,  sentiments,  and  emotions  of  normal  and 
abnormal  character  are  facts  as  real  as  are  physical  ob- 
jects, and  as  such  they  fall  into  the  domain  of  scientific 
research.     If  then  we  want  to  approach  these  facts 
from  a  strictly  scientific  standpoint,  it  would  be  high 
folly  to  study  them  by  methods  inappropriate  to  their 
nature.     We  may  as  well  ask    the   geometrician   to 
treat  lines  with  staining  fluids,  look  at  arcs  and  secants 
through  the  microscope,  cut  sines  and  cosines  with 
the  microtome,  measure  conic  sections  with  pints  and 
gallons,  weigh  parabolas  on  the  balance  with  ounces 
and  grammes.      Each  subject  matter  must  be  treated 
in  its  own  way  and  by  methods  specially  appropriate 
to  it.     Psychological  and  psychopathological  material 
being    essentially    of    a    subjective    nature    must   be 
studied  by  subjective  methods ;  subjective  accounts, 
introspective  analysis  and  interpretation   are  of  the 
highest  moment  in  the  study  of  the  relations  and  laws 


The  Subjective  Method  21 

of  psychological  and  psychopathological  phenomena. 
Not  even  the  highest  and  strictest  chemical  analysis 
can  reveal  as  much  as  the  least  insignificant  con- 
stituent of  a  fixed  idea,  nor  can  the  best  of  microscopes 
reveal  the  meanest  factor  of  an  illusion  or  hallucina- 
tion. Introspection  and  introspective  interpretation 
alone  can  lay  hold  of  a  psychic  fact. 

Because  of  this  subjective  side,  essential  in  psychosis 
along  with  the  introspective  aspect  requisite  in  all 
investigations  of  psychic  phenomena,  one  has  to  be 
very  careful  and  cautious  in  the  acceptance  of  his  facts. 
Only  a  close  critical  inspection  from  all  sides  possible 
can  justify  one  in  acceptance  of  the  full  truth  of  what 
has  been  given  to  him  as  introspective  statements  of 
a  subjective  experience.  ^  The  primary  requirement  is 
to  convince  oneself  of  the  intelligence  of  the  subject 
or  of  the  patient  so  as  to  be  sure  that  they  are  able  to 
give  a  correct  introspective  account  of  their  experi- 
ences. One  should  not  relinquish  continuous  ques- 
tioning and  should  always  be  on  his  guard.  For  the 
investigator  must  never  forget  that  the  psychic  facts 
occurring  in  others,  in  subjects  or  patients,  can  not  be 
gotten  at  in  a  direct  way,  but  only  in  an  indirect  way. 
The  nature  of  evidence  in  psychological  research  is 
essentially  of  a  circumstantial  character.  And  still 
the  facts  obtained  are  as  much,  if  possibly  not  more, 
of  a  reality  as  any  physical  facts  ;  for  he  who  denies 
reality  to  psychic  fact  denies  not  only  the  possibility 
of    all   sciences,   but  of    all  thought,    and    not    only 


22  Psychopathological  Researches 

contradicts  himself  in  the  very  act  of  his  denial,  but 
puts  himself  in  the  condition  of  the  insane  suffering 
from  the  delusion  of  the  unreality  of  his  inner  life- 
activity.  The  second  requirement  is  to  be  well  ac- 
quainted with  the  subject  or  patient  and  to  be  sure  of 
the  moral  trustworthiness  of  his  statements  and  de- 
scription of  his  subjective  experiences.  The  state- 
ments of  the  subject  or  patient  should  be  carefully 
sifted  and  ceaselessly  tested. 

Psychic  processes  should  be  studied  as  organic 
functions  are  by  the  physiologist  and  biologist. 
Psychic  functions  should  be  regarded  as  having  at 
least  equal  rank  with  other  functions  and  processes  of 
the  organism,  such  for  instance  as  digestion,  respira- 
tion, assimilation,  blood  circulation,  and  other  in- 
numerable physiological  functions. 

From  a  biological  and  physiological  standpoint  a 
psychic  process  should  be  regarded  as  a  function  of 
the  organism,  and  possibly  as  one  of  its  most  import- 
ant functions,  since  it  is  this  function  that  brings 
about  the  adjustment  and  adaptation  of  the  organism 
to  its  environment.  The  all-importance  of  this 
physiological  function  in  man's  life-history  can  hardly 
be  too  highly  overrated,  because  it  is  on  account  of 
the  high  development  of  the  psychic  function  that  he 
has  become  the  "lord  of  creation,"  the  victor  in  the 
struggle  for  existence  against  other  animals,  even  the 
creator  of  new  organs  in  the  shape  of  machinery, 
mechanical,  chemical,  and   electrical,  of  ever  greater 


The  Subjective  Method  23 

complexity, — new  organs  which  give  him  ever  greater 
control  over  his  environment.  It  is  this  psychic 
function  that  enables  man  to  penetrate  into  the  far 
past  of  bygone  ages,  into  the  history  and  develop- 
ment of  this  world — nay,  of  the  whole  universe  beyond, 
into  the  chasms  of  eons  to  come.  By  the  help  of  the 
psychic  function,  man  measures  the  velocity  of  light, 
he  weighs  the  distant  stars  in  the  balance,  and  ana- 
lyzes their  composition  in  a  ray  of  light ;  he  chains 
the  titanic  spirit  of  fire  and  works  him  as  his  drudge  ; 
he  employs  light  as  his  engraver,  orders  the  light- 
ning as  his  messenger,  and  makes  the  very  lips 
of  dumb  matter  resound  and  re-echo  with  human 
speech  and  emotions  ;  it  is  by  means  of  this  function 
that  man  overcomes  matter  and  force  and  breaks 
down  the  barriers  of  time  and  space.  A  function 
of  such  paramount  importance  in  the  biological  his- 
tory of  man's  existence  should  certainly  not  be  neg- 
lected, and  the  utmost  efforts  should  be  put  forth 
towards  the  gaining  of  a  more  or  less  precise  under- 
standing of  the  modus  operandi  of  its  constituent 
processes. 

It  is  true  that  in  order  to  approach  psychic  life  we 
must  go  about  it  in  an  indirect  way  ;  we  can  aim  at  it, 
so  to  say,  round  the  corner.  We  can  not  possibly 
directly  examine  the  phenomena  of  psychosis,  inso- 
far as  they  occur  externally  to  us,  in  others,  in  sub- 
jects, or  in  patients,  but  this  is  always  the  course  of 
nature.     The  inner  spring  of  natural  manifestations 


24  Psychopathological  Researches 

is  hidden,  and  especially  is  this  the  case  in  such  com- 
plexities as  are  presented  by  organic  life  phenomena 
in  general  and  by  psychic  processes  in  particular.  The 
inner  mechanism  of  natural  events  rarely  lies  on  the 
surface,  so  that  he  who  runs  may  read  ;  it  is  always 
enshrouded  in  darkness  and  mystery.  The  human 
mind,  however,  in  its  ever-restless  activity,  has  over- 
come many  a  difficulty,  and  by  the  powerful  instru- 
ments of  its  scientific  methods  has  penetrated  into  the 
most  inaccessible  regions  of  the  world  of  phenomena, 
and  by  the  intense  light  of  its  searching  thought  has 
dispelled  the  darkness  surrounding  many  a  deep 
recess  in  the  infinite  domain  of  nature.  Science  has 
wrenched  many  a  mystery  from  nature  and  shall 
wrench  many  more.  Psychosis  is  one  of  the  many 
great  mysteries  of  nature,  but  this  stonghold  too,  in- 
accessible as  it  now  seems,  is  bound  to  be  taken  by 
the  patient  siege  of  scientific  research  and  bold  assault 
of  the  daring  investigator. 


CHAPTER  V 

THE    ARTEFACTS    OF    PSYCHOPATHOLOGY 

The  investigator  becomes  specially  puzzled  when 
he  comes  in  contact  with  the  initial  stages  of  what  we 
may  call  functional  psychosis,  what  may  be  more  cor- 
rectly termed  as  psychic  dissociation,  and  what  is  com- 
monly known  under  the  name  of  "hysteria."  In 
functional  psychosis,  one  finds  himself  on  shitting 
sands,  so  to  say.  The  nature  of  those  psychophysio- 
logical phenomena  presents  such  an  extreme  insta- 
bility,—  the  symptoms  or  manifestations  are  so 
unstable,  so  ephemeral,  so  ill  defined  in  character  and 
form, — coming,  vanishing,  ceaselessly  playing  like  com- 
binations of  color  in  a  kaleidoscope,  ever  changing  and 
shifting  their  position  like  the  ever-restless  waves  on 
the  ocean,  no  wonder  that  many  an  investigator  feels 
at  sea,  turns  dizzy,  and  finally  becomes  nauseated  at 
the  whole  affair  and  gives  it  up  in  disgust.  This 
disheartening  state  of  things  becomes  to  many  minds 
all  the  more  intolerable,  because  a  good  many  of  the 
phenomena,  being  of  a  psychic  character,  necessarily 
depend  on  the  patient's  introspective  account,  and  one 
has  to  take  such  accounts  not  only  cum  grano  salts, 
but  often  almost  the  whole  of  them  have  to  be  entirely 

25 


26  Psychopathological  Researches 

distrusted.  Shamming,  simulation,  gross  lying,  and 
courses  of  deliberate  deception  frustrate  all  attempts 
of  the  earnest  scientist,  who  finally  gives  up  the  whole 
matter,  not  being  able  to  find  his  way  in  this  tangle  of 
deceit  and  conceit,  and  is  glad  to  leave  this  labyrinth 
of  lies,  sham,  and  fraud  for  something  more  real  and 
truthful  to  spend  his  time  upon.  The  story  is  told  of 
a  physician  who  had  devoted  a  good  deal  of  his  time 
to  an  interesting  case  of  a  young  lady  suffering  from 
"hysteria"  and  had  scrupulously  taken  detailed  notes 
on  the  subject.  One  day  the  young  lady,  in  a  con- 
fidential mood  before  she  left  the  physician's  office, 
told  him  she  had  one  thing  more  to  add,  and  that  was 
that  the  whole  thing  was  not  true.  One  can  imagine 
the  physician's  just  indignation.  He  never  after  took 
an  interest  in  any  sort  of  that  "sham  and  fraud." 

It  is  no  wonder  that  some  go  to  the  extreme  and  de- 
clare that  all  phenomena  of  psychic  character  are  noth- 
ing but  fraud,  or  as  some  have  termed  them  "innate 
cussedness."  Granted  that  there  is  a  good  deal  of 
"innate  cussedness"  in  some  cases  of  functional  psy- 
chosis, still  one  can  not  make  this  sweeping  statement 
in  all  cases.  In  throwing  away  the  husks  one  should 
be  careful  not  to  throw  away  the  kernel ;  gold  comes 
with  a  good  deal  of  sand,  and  diamonds  are  rarely 
found  without  a  quantity  of  gravel.  To  abandon 
metaphors,  in  all  sciences  the  initial  stages  of  natural 
processes  are  uncertain  and  ill  defined.  This  uncer- 
tainty increases  with  the  complexity  of  the  phenomena, 


The  Artefacts  of  Psychopathology         27 

and  in  organic  life  where  the  complexity  reaches  a 
very  high  degree  the  uncertainty  is  proportionately 
greater.  They  who  work  in  minute  microscopic  anat- 
omy know  how  disheartening  and  disappointing 
are  artefacts,  and  artefacts  in  microscopical  anatomy 
correspond  closely  to  the  illusory  "  facts "  of  the 
"  shams  and  frauds  "  of  functional  psychosis.  In  fact, 
we  may  regard  the  fraud  phenomena  of  psychosis  as 
the  artefacts  of  psychopathology.  In  cytology,  we 
know  how  uncertain,  almost  deceitful,  the  microscopic 
presentations  are,  as,  for  instance,  in  the  neurofibrils 
coursing  through  the  neuron,  or  the  intraconnections 
of  the  terminal  arborizations,  or  the  varicosities  found 
under  certain  conditions  in  the  dendrons  and  neur- 
axons  with  their  collaterals.  Similarly  uncertain  is 
the  whole  extent  of  biological  discussions  and  works 
clustering  round  the  function  and  role  of  the  centro- 
some  and  microsomes,  and  so  on.  One  could  mul- 
tiply, ad  infinitum,  instances  of  this  kind  taken  from 
various  branches  of  science.  No  one,  however,  will 
claim  that  it  is  nothing  but  a  waste  of  energy  to  spend 
time  and  labor  on  such  investigations  and  that  the 
whole  domain  of  cytology  and  biology  is  nothing  but 
a  snare  and  a  delusion. 

In  the  early  stages  of  science,  the  uncertainty  of  the 
phenomena  is  extreme,  —  myth  and  fraud  form  a 
good  portion  of  the  web  and  woof  of  early  science, 
which  even  at  its  best  is  inevitably  saturated  with 
metaphysics.      Physics    has    its    magic,    chemistry    is 


28  Psychopathological  Researches 

bound  up  in  alchemy,  astronomy  is  mingled  with 
astrology,  biology  and  medicine  are  organically  inter- 
woven with  spiritualism  and  incantations,  and  even 
mathematics  has  its  early  stages  of  magic  symbolism, 
as  one  can  witness  it  yet  in  the  magic  squares  now 
forming  amusement  and  play  in  leisure  hours.  Even 
in  Greek  civilization,  in  which  philosophy  and  science 
have  made  considerable  progress,  the  greatest  thinker 
of  the  age,  Socrates,  was  so  disappointed  with  the 
state  of  uncertainty  of  physics  and  astronomy  that  he 
turned  away  in  disgust  to  the  more  practical  and  more 
certain  knowledge,  that  of  man,  and  so  was  Hobbes  in 
modern  times  in  his  relations  to  the  scientific  inves- 
tigations of  the  English  Royal  Society. 

Patience  and  perseverance  are  the  great  virtues  of 
the  scientist.  In  spite  of  all  disappointments  and 
failures,  physicists  and  astronomers  went  on  working 
on  their  material  and  now  they  fall  but  short  of  the 
exact  mathematical  sciences.  We  must  not,  there- 
fore, be  disheartened  at  the  obstacles  in  psychopathol- 
ogy,  but  take  courage  and  work  at  them  with  all  the 
more  patience  and  ardor  in  proportion  as  the  difficul- 
ties are  greater. 

We  can  not  possibly  close  our  eyes  to  the  reality 
of  the  phenomena  of  psychic  nature  in  general  and 
those  of  psychopathic  character  in  particular,  lest  we 
be  like  the  baby  who  hides  himself  by  shutting  his 
eyes,  or  like  the  bird  that  puts  its  head  under  its 
wing  to  escape  from  imminent  danger.     One  can  not 


The  Artefacts  of  Psychopathology         29 

shut  out  the  world  by  ignoring  it.  The  wisdom  of 
science  is  to  look  with  eyes  wide'  open.  Because  a 
number  of  cases  are  snares  and  artefacts,  we  are  not 
in  the  least  justified  in  ignoring  the  whole  subject. 
We  do  not  throw  away  pearls  and  diamonds  because 
of  imitations. 

What  is  requisite  is  the  sharpening  and  training  of 
that  power  of  discernment  which  discriminates  be- 
tween the  false  and  the  genuine.  We  may  claim  that 
this  power  of  discernment  in  regard  to  psychic  facts 
is  not  yet  fully  developed  or  is  possibly  lacking  alto- 
gether, although  this  is  not  strictly  true,  but  it  will 
not  do  to  brush  the  whole  subject  aside  by  a  vague 
objection  of  "innate  cussedness."  First  of  all,  "in- 
nate cussedness  "  in  itself  may  make  a  psychic  trouble 
worth  while  studying ;  and  secondly,  all  types  and 
forms  of  psychic  troubles  are  subject  to  the  same 
taunting  criticism. 

The  multiform  types  of  aphasias  and  apraxias  are 
liable  to  similar  doubts  and  criticisms.  How  do  we 
know  that  all  those  different  aphasias  and  apraxias 
are  not  sham  and  simulation  ?  What  assures  us  of 
the  fact  that  the  aphasiac  is  not  an  impostor  and 
fraud  ?  The  patient  suffers  from  auditory  aphasia  ; 
we  speak  to  him  and  he  seemingly  does  not  under- 
stand us ;  he  can  not  write  from  dictation,  but  he  can 
write  spontaneously  ;  may  it  not  be  all  mere  fraud  and 
deception  ?  The  patient  suffers  from  visual  apraxia  ; 
we  show  him  a  shoe  and  he  tells  us  it  is  a  cat  or  a 


30  Psychopathological  Researches 

horse  ;  what  if  the  patient  simply  lies  systematically 
and  persistently  ?  The  patient  suffers  from  alexia  ;  he 
is  shown  words  which  he  claims  he  can  not  read,  but 
he  can  write  from  dictation  as  well  as  spontaneously  ; 
what  if  it  is  only  so  much  simulation,  "  innate  cussed- 
ness  "  ?  Are  not  all  the  forms  of  aphasias  and  apraxias 
subject  to  similar  criticisms  ? 

Delusions,  illusions,  hallucinations,  in  the  different 
forms  of  mental  alienation,  can  not  be  directly  known, 
and  the  investigator  depends  for  a  knowledge  of  them 
on  the  patient's  introspection.  One  can  not  directly 
perceive  fallacious  perceptions  and  false  systems  of 
ideas  occurring  in  other  people's  minds.  We  can  not 
see  other  people's  visions,  nor  can  we  feel  their  joys 
and  pains,  nor  can  we  directly  know  and  think  other 
people's  ideas  and  thoughts.  Not  even  the  mysti- 
cal agency  of  telepathy  can  accomplish  such  a 
miracle.  The  phenomena  of  mental  diseases  are 
essentially  subjective,  and  can  be  communicated  only 
by  the  individual's  own  introspective  account,  and 
as  such  they  are  uncertain,  dubious,  and  for  all  we 
know  may  be  only  sham  and  deception.  The  sys- 
tematized delusion  of  paranoia  may  be  only  deceit 
and  fraud  ;  the  actions,  hallucinations,  illusions,  and 
delusions  of  the  maniac,  melancholiac,  general  par- 
etic, paranoiac,  may  be  nothing  but  tissues  of  false- 
hood and  perverse  "  innate  cussedness."  In  fact,  all 
types  and  forms  of  insanity  may  be  so  many  varia- 
tions of  the  one  fundamental  trait  of  perverse  "  innate 


The  Artefacts  of  Psychopathology         31 

cussedness."  What  we  have  to  do  is  to  open  wide 
the  gates  of  the  asylums  and  hospitals  and  turn  loose 
the  insane. 

It  is  clear  that  no  one  will  for  a  moment  entertain 
such  an  extreme  and  untenable  position.  If,  then, 
such  a  position  can  not  possibly  be  maintained,  where 
shall  we  draw  the  line.  Where  do  the  real  forms  of 
mental  aberration  begin,  and  where  lies  the  province 
of  the  unreal,  of  sham,  simulation,  and  "  innate  cussed- 
ness "  ?  What  we  must  agree  to  is  the  indisputable 
fact  that  all  mental  ailments,  that  all  psychic  proces- 
ses, whether  they  be  normal  or  abnormal,  are  all  es- 
sentially "  innate''1  in  their  nature,  and  to  discard  them 
by  terming  them  "  cussed"  will  neither  explain  nor  help 
matters.  The  phenomena,  whether  they  be  "  innate 
cussedness  "  or  not,  are  there  and  can  not  be  ignored 
theoretically  or  practically.  The  only  way  out  of  the 
difficulties,  and  they  are  most  certainly  great  and 
grave,  is  to  accept  them  with  scientific  impartiality  of 
judgment  and  study  them  with  great  caution  and 
circumspection  in  such  order  as  the  processes  appear, 
in  a  series  from  the  early  to  the  later  stages,  the  early 
stages  requiring  our  special  attention,  since  they  are 
the  most  valuable  for  scientific  research,  though  the 
pitfalls  are  more  numerous  and  more  dangerous. 

The  practical  aspect  of  the  study  of  the  early  stages 
of  abnormal  mental  life  must  not  be  overlooked,  for  it 
is  in  the  early  stages  that  the  physician  is  enabled  to 
arrest  the  disease  process  which,  when  permitted  to 


32  Psychopathological  Researches 

reach  the  advanced  stages,  may  often  be  of  a  grave  or 
fatal  character.  In  this  respect  the  study  of  functional 
psychosis  is  invaluable.  The  scientific  men  of  the 
medical  profession  should  be  specially  interested  in 
the  investigation  of  the  problems  presented  by  func- 
tional psychosis,  because  the  manifestations  of  func- 
tional psychosis  lend  themselves  to  so  much  abuse 
by  all  kinds  and  forms  of  "fakes,"  "miracle  cures," 
abject  superstitions  and  prejudices  which  mar  and 
disgrace  civilized  humanity. 


Mental  Dissociation  in  Functional 
Psychosis 

By 

Boris  Sidis  and  William  A.  White 


CHAPTER    I 

HISTORY    AND    EXAMINATION 

D.  F.,  the  patient,  age  thirteen,  was  admitted  to 
the  Binghamton  State  Hospital,  April  8,  1897. 
According  to  the  medical  certificate,  the  patient 
"  previous  to  the  attack  was  quiet  and  modest ;  is 
now  boisterous  and  profane  ;  will  throw  anything  she 
gets  in  her  hands  at  any  one  she  sees  ;  has  said  if  she 
could  get  a  knife  she  would  kill  some  one  ;  breaks 
windows.  She  will  fight,  strike,  pull  hair,  try  to  pull 
boards  from  side  of  the  house ;  throws'  pillows  and 
bedclothes,  screams,  uses  vile  and  profane  language  ; 
has  to  be  watched  to  keep  her  from  climbing  out  of 
windows,  etc.  Struck  at  mother ;  tried  to  break  win- 
dow ;  laughs  violently  ;  sings  and  screams,  such  as  : 
1 1  want  a  pint  of  whiskey  ;  ha,  ha,  ha,  God  damn 
you  !     Sonny,  are  you  tired  ? '  " 

33 


34  Psychopathological  Researches 

Patient  is  of  a  neurotic  family  on  paternal  side  ; 
paternal  grandmother  was  insane  ;  father  committed 
suicide.     On  maternal  side  family  history  is  negative. 

Up  to  her  thirteenth  year  nothing  abnormal  had 
been  noticed  in  the  patient :  she  was  well  and  at- 
tended school  regularly.  About  the  16th  of  March, 
1897,  she  became  suddenly  disturbed  mentally;  she 
was  violent  and  excitable,  destructive,  using  profane 
and  obscene  language,  threatening  those  about  her 
with  personal  injury  ;  would  do  rash  acts,  thus  requir- 
ing the  constant  care  and  watchfulness  of  her  people. 

When  admitted,  she  would  not  talk  to  the  examin- 
ing physician,  and  is  described  in  the  case-book  as 
having  a  stupid,  somewhat  dazed,  look.  The  night 
of  her  admission,  and  the  following  morning,  she  had 
two  convulsive  seizures,  accompanied  by  abdominal 
pain  and  crying.  On  examination  in  the  morning,  she 
presented  marked  tremor  of  the  right  hand,  was 
reticent,  and  had  no  recollection  of  the  facts  which  led 
to  her  commitment  as  insane.  It  was  noted  that  she 
could  not  see  well.  She  complained  that  after  a  short 
application  to  reading  the  words  on  the  page  became 
blurred  and  indistinct.  An  examination  of  her  field 
of  vision  showed  a  marked  contraction,  the  maximum 
range  being  only  250  (see  Figure  1).  Vision  was, 
however  :  OS  20/15,  .50  astigmatism  ;  OD  20/15,  .50 
astigmatism  ;  the  right  disc  was  hypersemic. 

A  physical  examination  revealed  the  fact  that  the 
patient  possessed  a  moderately  sized  goitre  and  that 


History  and  Examination  35 

she  had  not  yet  menstruated.  No  other  physical 
abnormalities  were  found  and  the  rest  of  her  bodily 
functions  were  normal. 

An  examination  of  the  patient's  general  sensibility 
in  the  waking  state  gave  the  following  results  : 

Localization  of  touch.     Eyes  closed. 

Hand  :  Pointed  out  precise  place  immediately  after 
touch.  A  few  seconds  later  (about  5  sec.)  pointed 
out  about  2  mm.  farther. 

Tip  of  nose  :  Pointed  out  correct  right  after,  and 
1  mm.  farther,  from  memory.  Cheek  and  chin  :  Cor- 
rect right  after,  and  2  mm.  removed  5  sec.  later. 

Legs  :  Immediately  after  touch  stimulation,  correct ; 
from  memory  (5  sec.  later),  1  mm.  removed. 

Localization  of  sound.     Eyes  closed. 

Five  out  of  eight  cases  correct ;  direction  of  sound 
correct. 

Watch  ticking  heard  56  cm.  from  left  ear. 
"  "  "      48  cm.  from  right  ear. 

When  watch  was  moved  toward  ear  from  a  region  in 
which  it  could  not  be  heard,  the  distance  was  dimin- 
ished ;  when  moved  in  opposite  direction,  distance 
increased. 

Differentiation  between  dull  and  sharp  points  : 

Pressure  20  on  forehead,  one  trial,  correct. 
"         30  on  back  of  hand,  one  trial,  correct. 

20         "  "  "         "  " 

"  10  on  palm,  two  trials,  correct. 

U  ,,.  U  «  it  «< 


UJ 

IT 

o 


History  and  Examination  37 

Patient  was  blindfolded, — letters,  figures,  etc.,  drawn 
on  left  forearm,  patient  given  pencil  and  paper 
and  asked  to  reproduce  immediately  the  outlines  of 
figures  or  letters.  Results  negative.  There  was  a 
tendency  to  reverse  figures  drawn. 

When  blindfolded  movements  communicated  to  fin- 
gers and  arm  were  correctly  reproduced  with  other 
hand  and  arm. 

The  field  of  vision  for  white,  red,  blue,  and  green 
were  taken.  The  field  of  color  vision  showed  reversal. 
(See  Figure  2.) 

Objects  were  introduced  into  anaesthetic  portion  of 
field  and  she  was  asked  to  guess  what  they  were:  first, 
the  particular  character  of  objects,  and,  when  this  could 
not  be  guessed,  their  general  character.  The  general 
character,  such  as  piece  of  paper,  could  be  guessed 
in  a  wider  field  than  the  particular  character,  i.  e.,  the 
letter  or  figure  on  the  paper.1     (See  Figure  3.) 

Very  sensitive  to  different  colors  ;  picks  them  out 
at  once,  matches  them  perfectly.  Picks  out  of  a 
basket  of  woollen  yarns  light  colors  by  preference. 

The  sense  of  smell  was  highly  discriminative. 

The  dynamograph  gave  the  following  results  : 


WAKING 

STATE. 

HYPNOSIS. 

1st  trial : 

R.  H. 

75 

R.  H.     70 

L.  H. 

75 

L.  H.     56 
Suggestion  of  lack  of  strength. 

2d  trial : 

R.  H. 

65 

R.  H.     28 

L.  H. 

54 

L.  H.     25 

Suggestion  of  strength. 

R.  H.     80 

L.  H.     60 

1  For  a  full  discussion  of  the  method  of  guessing  in  relation  to  the  general 
and  particular  character  of  subconsciously  perceived  impressions,  see  Psychology 
of  Suggestion,  pp.  165-176. 


&! 


I 


I 


I 


« 


I 


u 


o 
6 


> 


2  ■- 

I 

I 

I 
I 

1 


40  Psychopathological  Researches 

To  test  the  patient's  immediate  desultory  memory, 
eight  syllables  were  given  her.  In  the  waking  state 
she  repeated,  immediately  after,  two  correctly.  Of  the 
same  number  of  syllables  given  in  the  hypnotic  state 
she  repeated  four  correctly. 

Eight  numbers  were  given  as  memory  test  in  the 
waking  state.  Patient  repeated  immediately  two  cor- 
rectly. In  the  hypnotic  state,  out  of  eight  numbers, 
five  were  correctly  remembered. 

The  hypnotic  state  thus  showed  a  far  better  desul- 
tory memory  than  was  found  in  the  waking  state. 
Memory  in  the  waking  state  was  rather  poor,  but 
subconscious  memory  proved  to  be  good. 

Motor  reactions  were  delayed,  and  tests  by  auto- 
matograph  in  the  waking  state  clearly  revealed  the 
presence  of  subconscious  motor  reactions.  (See 
Plates  IX.  and  X.) 

On  the  whole,  it  may  be  said  that  with  the  abate- 
ment of  the  maniacal  state  the  sense  of  sight  and  that 
of  kinaesthesis  alone  showed  disturbances  ;  all  the 
other  senses  were  normal. 

With  the  pneumograph,  tracings  were  taken  of  the 
patient,  first  under  normal  conditions  without  any 
stimuli,  and  afterward  under  the  influence  of  different 
stimuli.     (See  Plates  I.  and  II.) 


CHAPTER   II 

EXAMINATION    OF    THE    SUBCONSCIOUS 

To  test  whether  the  case  was  of  an  organic,  neuro- 
pathic, or  psychopathic  character,  the  method  of  guess- 
ing was  used.  The  method  of  guessing  consists  in  the 
making  of  impressions  on  the  anaesthetic  organ,  and 
the  subject,  not  perceiving  any  of  the  applied  stimuli, 
is  asked  to  guess  as  to  the  nature  and  number  of  them 
by  telling  anything  that  happens  immediately  to  enter 
the  mind.  The  patient  was  placed  before  the  perimeter 
and  objects  were  introduced  midway  between  her  field 
and  the  normal  field.  These  objects  were  outside  the 
patient's  field  of  vision,  but  if  asked  to  guess  what  they 
were,  stopping  a  few  moments  to  think  and  naming 
the  first  object  which  came  to  her  mind,  her  answers 
were  correct.  Letters  were  introduced  into  the  per- 
imeter, of  the  same  size  as  the  disc  used  for  determin- 
ing the  field  ;  she  could  often  guess  the  correct  letter, 
although  she  could  not  see  it,  but  when  it  was  near  the 
limits  of  her  field  she  often  had  a  perception  of  white 
without  being  able  to  see  the  letter. 

Under  hypnosis  it  was  suggested  to  her  that  her 

field  would  enlarge,  that  her  vision  would  improve, 

and  that  she  would  be  able  to  use  her  eyes  better  for 

41 


42  Psychopathological  Researches 

reading  and  sewing.  On  awaking  from  the  hypnotic 
state,  tests  with  the  perimeter  showed  a  markedly 
increased  visual  field,  and  there  was  some  improve- 
ment in  her  ability  to  use  her  eyes,  but  not  as  much 
as  would  have  been  expected  from  the  increased  size 
of  the  field  of  vision.  The  fields  of  vision  taken  im- 
mediately after  this  hypnotic  state  showed  a  marked 
tendency  to  change  continually  —  dilating  and  con- 
tracting along  certain  angles  from  50  to  150,  and  finally 
lapsing  into  the  original  state.  We  may  add  here 
that  the  contracted  field  of  vision  which  constitutes 
the  central  symptom  of  this  case  could  only  be  tran- 
siently affected  by  hypnotic  suggestion.  In  spite  of 
the  fact  that  suggestions  given  during  the  hypnotic 
state  were  most  emphatic,  the  field  of  vision  could  not 
be  permanently  enlarged. 

The  subject  manifested  a  tendency  to  fall  into  deep 
somnambulism  with  complete  amnesia  in  the  waking 
state.  She  was  unable  to  open  her  eyes  when  told 
that  she  could  not,  and  equally  unable  to  prevent  the 
arm  from  rising  to  a  level  with  the  shoulder  when  told 
it  would.  If  she  was  told  that  she  could  not  lower 
the  arm  when  in  this  position,  it  remained  there  indefi- 
nitely, and  all  her  efforts  to  lower  it  were  futile.  Rota- 
tion of  the  hands  about  one  another,  if  started,  was 
continued,  and  if  they  were  held  a  moment,  they  im- 
mediately flew  apart  when  released  and  continued  the 
motion.  Complete  anaesthesia  could  be  produced  by 
suggestion,  and  the  patient  was  completely  unconscious 


Examination  of  the  Subconscious        43 

of  any  movements  communicated  to  the  anaesthetic 
limb,  and  could  not  tell  where  it  was  without  the  aid 
of  vision.  If  now  one  arm  only  was  made  anaesthetic 
and  both  arms  were  raised  to  a  level  with  the  shoulder, 
the  patient  meanwhile  having  her  eyes  closed,  the  anaes- 
thetic arm  trembled  less,  sank  more  slowly  to  the  side, 
and  when  it  finally  dropped,  after  having  remained  up 
longer  than  the  other,  it  did  so  in  a  heavier,  more 
lifeless  manner.  If  all  the  limbs  were  made  anaesthetic 
and  the  subject  with  her  eyes  closed  was  directed  to 
rise  and  take  two  steps  forward,  she  did  so,  but  in 
answer  to  inquiries  said  that  she  was  not  aware  of 
having  moved. 

Both  positive  and  negative  visual  hallucinations  of 
persons  and  things  could  be  given  by  suggestion.  If 
a  person  rendered  invisible  to  her  was  placed  in  her 
path  while  walking,  she  ran  directly  into  him  and 
tried  to  walk  on,  pushing  by  him,  and  appearing 
entirely  unconscious  of  his  presence.  She  could  not 
explain  when  questioned  what  had  interfered  with  her 
progress.  This  negative  hallucination  did  not  extend 
to  objects  handled  by  the  invisible  person.  They 
seemed  to  her  as  if  suspended  in  mid-air,  and  she  could 
give  no  explanation  of  this  incongruous  appearance. 
On  one  occasion  she  was  told  that  an  empty  chair  op- 
posite contained  Dr.  E.,  that  he  was  speaking  to 
her,  and  she  was  expected  to  answer  him.  She  said 
that  she  saw  Dr.  E.,  but  did  not  converse  with  him 
as  she  did  not  hear  him  address  her.     She  would 


44  Psychopathological  Researches 

see  imaginary  columns  of  figures  on  blank  paper, 
read  them,  and  add  them  all,  or  any  combination  of 
them  ;  but  the  number  of  figures  in  each  instance 
which  she  saw  never  exceeded  four.  In  the  same  way 
she  saw  photographs  on  blank  paper,  and  when  asked 
whose  pictures  she  saw  she  usually  gave  the  names  of 
the  nurses.  If  a  letter  of  the  alphabet  was  eliminated 
from  her  mind  by  telling  her  she  could  neither  see, 
pronounce,  nor  write  it,  she  repeated  the  alphabet 
promptly,  omitting  the  letter,  and  copied  passages  from 
books  leaving  the  letter  out  wherever  it  occurred. 

While  in  a  hypnotic  state,  a  nurse  was  introduced 
to  her,  whom  she  had  never  seen  and  whose  name  she 
did  not  know,  and  after  telling  her  the  name  she  was 
told  that  when  she  awoke  she  would  ask  me  for  pencil 
and  paper  and  write  the  name.  On  awaking,  she 
had  no  knowledge  of  ever  having  seen  the  nurse,  who 
still  was  in  the  room,  and  made  no  spontaneous  effort 
to  carry  out  the  suggestion.  When  asked  if  she  did 
not  feel  as  though  there  was  something  which  she 
should  do,  she  tried  to  think,  but  failed  to  recall  any- 
thing. Finally  she  had  to  be  assisted  by  telling  her 
that  she  was  to  ask  for  something,  whereupon,  after  a 
few  moments'  thought,  she  asked  for  pencil  and  paper 
and  promptly  wrote  the  name.  « 

In  every  instance  where  she  was  given  a  suggestion 
to  be  carried  out  in  the  waking  state,  it  was  found 
necessary  to  assist  to  this  extent,  but  when  once  the 
act  was  initiated  it  was  completed  accurately.     After- 


Examination  of  the  Subconscious       45 

wards,  however,  this  assistance  became  no  longer 
necessary.  The  many  experimentations  seemed  to 
have  cultivated  in  her  the  spirit  of  obedience  to  sug- 
gestions. 

On  another  occasion  she  was  given,  during 
hypnosis,  a  blank  piece  of  paper  upon  which  she  was 
told  there  was  a  column  of  figures.  When  asked  to 
read  the  figures,  she  read  four  numbers,  giving  a  dif- 
ferent order  on  a  second  interrogation,  but  maintain- 
ing this  second  order  throughout  the  experiment. 
She  was  told  that  on  awaking  she  would  see  these 
numbers  and  add  them.  With  similar  assistance 
to  that  described  in  the  foregoing  experiment,  she 
took  a  pencil,  drew  a  line  as  if  under  a  column  of 
figures,  and  wrote  down  the  correct  sum — 21.  When 
questioned,  she  said  she  had  seen  no  figures,  but  had  ' 
drawn  the  line  to  add  and  written  21  simply  because 
that  was  the  first  number  that  came  to  her  mind. 
Finally,  when  asked  what  she  had  added,  she  repeated 
the  figures  seen  during  hypnosis,  and  gave  them  as  a 
reason  for  the  sum  21,  but  she  could  not  account  for 
the  particular  numbers.  They  appeared  to  her  as  if 
they  had  accidentally  occurred  to  her  mind. 

Anaesthesia  of  the  right  arm  was  produced  during 
hypnosis,  and  it  was  suggested  that  this  condition 
would  continue  in  the  waking  state,  which  it  did. 
The  anaesthetic  arm  was  insensible  to  pin-pricks,  and 
with  the  eyes  closed  she  could  not  locate  it.  The 
arm  was  carried  in  a  limp,  helpless  way,  but  she  was 


46  Psychopathological  Researches 

able  to  use  it  in  grasping  objects,  playing  cards,  etc., 
and  in  holding  a  heavy  book  between  thumb  and  fin- 
gers even  with  closed  eyes. 

On  one  or  two  occasions,  however,  while  she  was 
playing  cards  and  holding  the  cards  in  the  anaes- 
thetic hand,  on  looking  away  from  the  hand  the  cards 
dropped  to  the  floor. 

With  her  eyes  tightly  closed,  the  fingers  and  arm 
were  moved  several  times  in  the  same  direction. 
When  left  alone,  these  movements  were  continued 
automatically  and  without  her  knowledge.  In  the 
same  way,  if  a  pencil  was  placed  in  the  fingers  and 
the  hand  started  writing  a  figure,  letter,  or  simple 
word,  it  completed  the  movement,  although  she  did 
not  even  know  that  she  held  a  pencil. 

If,  with  eyes  closed,  she  was  asked  to  think  of  a 
number,  and  the  hand  was  pricked  several  times,  al- 
though no  sensation  resulted  she  invariably  thought 
of  a  number  corresponding  to  the  number  of  pricks 
made. 

All  these  experiments  were  conducted  with  the 
same  results  during  hypnosis.  This  anaesthesia  was 
allowed  to  remain  about  three  hours,  and,  as  it  seemed 
to  worry  her  somewhat,  was  removed  by  hypnotic 
suggestion. 

The  subject  in  her  normal  state  was  given  a  book  ; 
she  was  directed  to  read  aloud  to  some  one  in  the 
room,  in  a  slow,  clear  tone,  taking  pains  meanwhile  to 
understand  clearly  what  she  was  reading.     While  she 


Examination  of  the  Subconscious       47 

was  reading,  Dr.  W.  approached  her  from  behind  and 
spoke  to  her  in  a  low  tone  of  voice,  directing  her  to 
raise  her  right  hand  to  the  table  ;  the  hand  obeyed  ; 
Dr.  W.  placed  a  pencil  in  the  hand,  and  the  hand 
grasped  it.  Now  any  question  that  was  propounded 
to  her  was  answered  in  writing  while  she  continued  to 
read  aloud.  If  a  suggestion  of  a  visual  hallucination 
was  given  to  her,  the  hand  wrote,  in  reply  to  a  ques- 
tion, that  she  saw  the  thing  suggested.  It  was  notice- 
able, however,  that  the  two  processes  interfered  with 
one  another,  and  that  while  one  was  carried  on  at  its 
best  the  other  was  interrupted  and  hesitating.  When 
she  stopped  reading,  she  had  no  recollection  of  any- 
thing said  or  suggested,  and  her  remembrance  of  what 
she  had  read  was  rather  indistinct.  If,  however,  she 
was  hypnotized  after  one  of  these  experiments,  she 
remembered  everything  said  and  what  her  written 
replies  had  been.  When  questioned  once  during  this 
period  of  distraction  about  a  hallucination  of  a  rose 
which  had  been  given  her  in  a  former  hypnotic  state, 
and  asked  if  she  remembered  it,  the  hand  wrote 
"Yes"  ;  asked  what  she  did  with  it,  the  hand  wrote 
"  I  gave  it  to  Mrs.  S.,"  which  was  a  correct  answer 
and  showed  complete  recollection  of  the  hallucination. 
Questioned  after  she  finished  reading,  she  had  no 
recollection  either  of  the  hypnotic  state  or  of  the 
answers  her  hand  had  written. 

If  in  her  normal  state  she  was  placed  at  a  table  with 
pencil  and  paper  in  the  attitude  of  writing  and  with 


48  Psychopathological  Researches 

closed  eyes  asked  to  think  intently  of  a  name,  the 
hand  soon  began  automatically  and  without  her 
knowledge  to  write  this  name.  This  experiment  has 
been  duplicated  with  the  hand  made  anaesthetic  by  sug- 
gestion both  during  hypnosis  and  post-hypnotically. 

All  these  experiments  were  made  without  in  any 
way  suggesting  to  the  patient,  or  indicating  in  her 
presence,  what  were  the  expected  results,  and  a  care- 
ful observation  of  her  since  admission  has  failed  to 
detect  any  evidence  of  simulation. 

Since  her  admission,  she  had  no  further  nervous 
crises,  except  those  described  above,  until  the  after- 
noon and  night  of  June  12th  and  13th.  This  attack 
was  convulsive  in  nature  and  accompanied  by  marked 
spasms  and  dyspnoea. 


CHAPTER  III 

EXPERIMENTS    ON    THE     INTELLIGENCE    OF    DISSOCIATED 
SUBCONSCIOUS    SYSTEMS 

We  have  found  that  under  certain  conditions  phe- 
nomena are  induced  of  which  the  patient  herself 
is  not  conscious.  The  patient  carries  out  certain 
acts,  does  certain  things,  and  is  unable  to  know  any- 
thing about  them.  Changes  in  sensibility  are  also 
induced  —  such,  for  instance,  as  anaesthesia,  anal- 
gesia, etc.  The  question,  therefore,  before  us  is 
this  :  Are  the  acts  of  the  patient  of  an  automatic 
character, —  a  sort  of  reflex  activity  of  the  organism 
without  any  accompanying  consciousness, —  or  have 
they  a  psychic  concomitant  ?  In  other  words,  are  the 
acts  carried  out  by  an  unconscious,  wound-up,  physio- 
logical mechanism,  or  is  there  an  accompanying  intel- 
ligence, limited  though  in  range,  but  rational  enough 
to  carry  out  the  acts?  In  the  cases  of  changes  of 
sensibility, —  such,  for  instance,  as  anaesthesia  and 
analgesia, — the  problem  is  of  the  same  nature  :  Are  the 
stimuli  really  not  perceived  by  the  patient, —  such,  for 
instance,  as  we  find  in  the  anaesthesia  and  analgesia 
of  an  organic  character, — or  are  they  only  absent 
from  the  patient's  limited  personal  consciousness,  but 

4  49 


5o  Psychopathological  Researches 

perceived  by  dissociated  subconscious  systems  ?  With 
this  problem  in  mind  the  following  experiments  were 
performed  : 

During  the  hypnotic  state  Dr.  W.,  to  whom  the 
patient  was  accustomed,  remained  alone  en  rapport 
with  her.  She  remained  insensible  to  the  touches 
and  also  the  pricks  and  other  pain  stimuli  given  her 
by  outsiders.  She  did  not  react  to  any  stimuli  coming 
from  outsiders  and  in  reply  to  an  interrogation  by 
Dr.  W.  said  that  she  perceived  nothing  at  all.  The 
most  painful  stimuli  seemed  to  have  left  her  unaf- 
fected, showing  that  for  all  practical  clinical  purposes 
she  had  not  felt  them.  To  prove,  however,  that  she 
did  feel  all  these  stimuli  ;  that  she  really  did  hear 
what  was  said  to  her  ;  that  she  really  did  perceive 
everything  that  was  going  on  about  her,  being  only 
seemingly  unconscious  of  it,  while  the  experiences 
were  really  present  in  and  perceived  by  the  subcon- 
sciousness dissociated  from  the  upper  consciousness, 
experiments  were  made  by  the  methods  of  associative 
suggestion. 

The  method  of  associative  suggestion  consists  in 
the  formation  of  a  subconscious  association  between  a 
subconsciously  felt  stimulus  and  a  consciously  expe- 
rienced percept  or  concept.  The  subconsciously 
perceived  stimulus  is  projected  into  the  upper  con- 
sciousness in  the  form  of  an  idea,  and  the  intermedi- 
ate link  is  lost. 

Associative  suggestion  may  be  divided  into  mediate 


Intelligence  of  Dissociated  Systems       51 

and  immediate.  The  method  of  mediate  associative 
suggestion  consists  not  in  the  realization  of  the  sug- 
gestion itself,  but  of  something  associated  with  it. 
The  subject  does  not  perceive  certain  stimuli  directly, 
but  reacts  always  in  a  definite  form  when  these  stimuli 
are  impressed  so  that  this  reaction  becomes  associated 
with  the  stimuli. 

Immediate  associative  suggestion  consists  in  the 
formation  of  associations  between  impressions  of  stim- 
uli subconsciously  felt  and  ideas  corresponding  to 
those  subconscious  perceptions  in  the  patient's  per- 
sonal consciousness.  The  patient  does  not  feel  the 
stimuli,  but  when  asked  to  tell  the  first  idea  that 
comes  to  her  mind  the  ideas  are  found  to  correspond 
exactly  with  the  stimuli. 

By  these  methods  the  following  experiments  were 
carried  out  : 

Dr.  W.  to  D.  F.  :  As  soon  as  Dr.  S.  speaks  to  you, 
if  you  do  not  hear  him,  say,  "  No." 

Dr.  S.  spoke  to  her  and  asked  her  if  she  heard  him 
and  she  immediately  answered,  "  No." 

Dr.  W.  to  D.  F.  :  Dr.  S.  is  in  the  room;  you 
cannot  hear  anything  he  says,  but  when  he  counts 
up  to  five  you  say,  "  No  "  ;  and  when  he  counts  to 
ten,  say,  "Yes." 

Dr.  S.  talked  to  her,  but  no  response.  When  he 
counted  five,  she  said,  "  No"  ;  and  when  he  counted 
ten,  she  said,  "Yes."  Dr.  S.  presented  acetic  acid  to 
nose  ;  it  produced  a  very  slight  reaction. 


52  Psychopathological  Researches 

Dr.  W.  told  D.  F.  she  could  not  feel  pricks,  but 
that  every  time  Dr.  S.  pricked  her  she  would  count 
the  numbers.  This  she  did,  but  said  she  could  feel 
nothing. 

Dr.  W.  to  D.  F.  :  You  can  hear  nothing  Dr.  S. 
says,  but  he  will  ask  questions,  and  you  will  give  me 
the  answers. 

Dr.  S.  asks,  "How  much  is  4  times  4?"  D.  F. 
says,  "  16."  Dr.  S.  asks,  "  How  much  is  5  times  5  ?" 
D.  F.  says,  "  25,"  etc.,  to  many  questions. 

Dr.  S.  :  Do  you  hear  me  ? 

D.  F.  :  No. 

Dr.  W.  to  D.  F.  :  You  feel  nothing  Dr.  S.  does. 

Dr.  S.  gives  her  electric  current  of  great  intensity. 
She  does  not  react,  as  she  would  in  the  normal  waking 
state,  and  says  she  feels  nothing. 

Dr.  W.  says  to  D.  F.  :  You  cannot  feel  anything 
nor  hear  Dr.  S.  speak,  but  he  will  count  and  as  he 
counts  you  will  tell  whether  you  feel  pain,  or  want 
the  electricity  stopped. 

Dr.  S.  then  used  the  electricity  without  counting  and 
she  said  she  felt  nothing,  and  when  he  counted  she 
said,  "  Electricity." 

Dr.  W.  told  D.  F.  :  When  Dr.  S.  touches  your 
hand  you  will  feel  nothing,  but  you  will  point  out  the 
place  he  touches. 

This  she  does,  but  says  in  answer  to  questions  of 
Dr.  W.  that  she  feels  nothing. 

Dr.  W.  told  D.  F.  she  could  not  hear  Dr.  S.,  but 


Intelligence  of  Dissociated  Systems       53 

would  tell  Dr.  W.  everything  that  came  in  her  mind. 
When  Dr.  S.  told  her  she  would  like  to  take  a  walk, 
or  read  a  book,  she  told  Dr.  W.  that  she  would  like 
to  go  for  a  walk,  or  read  a  book. 

These  experiments  indicate  more  or  less  clearly  that 
experiences  are  actually  present  to  the  patient's  con- 
sciousness, although  the  patient  herself  seems  to  be 
unconscious  of  them.  The  stimuli  impressed  on  the 
patient's  sense-organs  are  perceived,  co-ordinated, 
recognized  by  systems  dissociated  from  the  principal 
functioning  constellations  constituting  for  the  time 
present  the  patient's  personal  consciousness.  That 
these  dissociated  systems  are  of  a  conscious  nature  is 
clearly  seen  from  the  fact  that  they  are  able  to  per- 
ceive different  stimuli,  such,  for  instance,  as  touch, 
pricking,  electricity,  etc.,  and  furthermore  are  able  to 
count  and  give  answers  to  questions. 

The  character  of  the  methods  employed  in  these 
experiments  indicates  at  the  same  time  that  if  there 
be  a  dissociation  by  habitual  tracts  there  must  be 
an  indirect  association  by  unhabitual  tracts  ;  for  the 
answers  and  the  fact  that  these- stimuli  were  actually 
perceived  could  be  brought  out  in  an  indirect  way  ; 
the  patient  giving  replies  of  such  a  nature  as  to 
clearly  indicate  the  presence  of  these  experiences  in  a 
subconscious  form  within  her  mind.  The  patient,  for 
instance,  is  not  able  to  feel  touch  or  pain  stimuli,  but 
is  still  able  to  tell  their  number. 

The  experiments    carried    on    by  the    methods   of 


54  Psychopathological  Researches 

associative  suggestion  show  that  the  same  holds  true 
of  more  complex  stimuli,  such,  for  instance,  as  speech. 
The  subconscious  dissociated  systems  were  able  to 
comprehend  speech  and  could  give  answers,  although 
the  patient  herself  was  seemingly  not  directly  con- 
scious of  them.  Thus,  for  instance,  when  a  question 
was  propounded  to  her  she  apparently  did  not  hear 
the  words,  did  not  hear  even  the  sounds,  and  still  she 
gave  replies  perfectly  in  accord  with  the  questions, 
not  being  at  the  same  time  conscious  of  the  meaning 
of  the  words  which  she  uttered.  The  phrases  in  which 
she  couched  her  answers  were  meaningless  to  her 
and  when  asked  what  she  meant  by  the  words  and 
phrases  said  she  did  not  know.  When  further  asked 
why  she  made  the  remarks  she  answered  that  some- 
thing unaccountable  urged  her  to  make  them. 


CHAPTER  IV 

SUBCONSCIOUS    REACTIONS 

Psychomotor  reactions  of  subconscious  systems  to 
external  stimulations  may  have  their  parallel  in  cases 
of  insistent  ideas  or  phrases  which  come  up  unac- 
countably to  consciousness  and  have  to  be  pronounced 
whether  the  patient  will  or  no.  The  subconscious  dis- 
sociated systems  seem  to  have  taken  possession  of  the 
patient's  organs  of  speech  and  have  given  the  answers 
to  questions  without  her  knowledge.  It  may  be  that 
the  dissociated  systems  simply  send  up  their  reply  in 
an  insistent  form  and  the  patient  has  to  pronounce 
the  answer.  In  this  case  it  is  the  personal  conscious- 
ness that  is  indirectly  made  to  answer  and  the  patient 
is  first  conscious  of  the  words  or  phrases  before  they 
are  pronounced.  It  may,  however,  be  as  we  have 
just  suggested, —  that  the  subconscious  dissociated 
systems  possess  themselves  of  the  patient's  organs  of 
speech  and  make  the  reply  directly.  In  this  case 
the  answer  does  not  come  up  in  the  form  of  an  insist- 
ent idea  and  the  patient  becomes  conscious  of  the 
answer  only  after  it  has  been  given. 

In  some  of  the  experiments,  however,  it  is  clear 
that  the    first    case   holds   true,  because  the  patient 

55 


56  Psychopathological  Researches 

when  questioned  replied  that  she  had  said  the  first 
thing  that  came  into  her  mind.  Furthermore,  in 
those  experiments  which  were  carried  on  by  the 
method  of  guessing,  or  by  the  method  of  immediate 
associative  suggestion,  where  the  patient  had  to  tell 
anything  that  came  into  her  mind,  and  she  was  thus 
giving  correct  answers,  it  was  evident  that  the  first 
case  held  true. 

As  an  example  of  the  second  case,  we  give  the 
following  experiments  : 

Dr.  S.  gets  D.  F.  up  out  of  one  chair  and  puts  her 
in  another.  When  questioned  she  said  she  was  in  the 
same  chair  in  which  she  had  first  sat  down  and  gone 
to  sleep. 

Dr.  W.  to  D.  F.:  You  will  open  your  eyes  but 
you  will  be  unable  to  see  Dr.  S. 

Dr.  S.  talks  to  her  continually,  but  she  avoids  look- 
ing at  him.  When  asked  to  look  about  for  him,  looks 
everywhere,  but  not  in  the  direction  where  he  is. 
When  he  holds  up  his  hand  she  says  she  sees  nothing. 
If  Dr.  W.  holds  up  an  object  back  of  Dr.  S's  hand 
(which  object  she  has  not  seen)  and  asks  her  what 
it  is,  she  says  it  is  Dr.  W's  hand. 

Dr.  W.  takes  a  hat.  She  sees  it.  Dr.  W.  gives  it 
to  Dr.  S.  and  he  puts  it  on,  and  the  hat  appears  to 
her  as  if  suspended  in  air.  She  was  told  she  could 
not  see  Dr.  S's  glasses,  but  when  they  moved  she 
would  say  "  Yes  "  ;  she  does  this,  following  the  glasses 
with  her  eyes.     Why  she  does  this  and  why  she  says 


Subconscious  Reactions  57 

"  Yes "  she  does  not  know,  but  says  she  could  not 
help  it. 

When  Dr.  S.  puts  a  lighted  match  to  her  eyes,  the 
pupils  react.  Sclerotic  sensitive  to  touch,  but  reaction 
very  slight. 

She  was  told  to  walk  to  another  chair.  Dr.  S.  held 
her  hand  and  prevented  her  going.  She  resisted 
for  some  time,  but  afterwards  remained  passive  and 
made  no  further  attempts  to  go.  When  asked  why 
she  did  not  go,  she  answered  she  could  not,  some- 
thing in  the  air  prevented  her.  She  does  not  look  at 
Dr.  S.,  but  continually  smiles.  Dr.  S.  holds  up  a  fin- 
ger, which  she  is  told  she  cannot  see,  but  will  follow  it 
with  her  eyes.  She  does  not  see  it,  but  pupils  react 
to  accommodation. 

Dr.  S.  holds  up  newspaper,  and  tells  her  she  cannot 
see  it  or  his  hand,  but  when  finger  points  to  word  she 
will  pronounce  it.  This  she  does,  but  immediately 
after  cannot  recall  the  words.  If  asked  to  recall  them 
and  the  finger  points  to  the  words,  she  repeats  them. 
When  the  paper  is  removed  she  does  not  know  what 
she  has  said.  Suggestions  were  given  by  Dr.  W. 
that  she  could  not  remember  the  words,  but  could 
write  them.  She  takes  pen,  and  writes  them.  Asked 
if  they  are  the  words,  says  she  "don't  know"  ;  says 
she  wrote  them  because  she  could  not  help  it. 

An  attempt  was  also  made  to  experiment  in  per- 
sonality metamorphosis.  A  suggestion  was  made  that 
she    was    a    child   two   years    old.       She    claimed    in 


58  Psychopathological  Researches 

answer  to  questions  that  she  was  two  years  old, 
and  it  took  a  special  suggestion  to  remove  this  idea 
from  her  mind,  but  there  was  really  no  organization 
of  a  child  personality ;  she  did  not  behave  as  one 
would  expect  of  a  child,  and  she  was  able  to  write 
without  the  least  change.  This  may  be  explained  by 
the  fact  that  the  patient  was  extremely  young,  and  her 
store  of  experiences  was  rather  meagre.  She  had  not 
sufficient  mental  material  to  personate  the  individual- 
ity suggested  to  her. 

On  awaking  at  the  end  of  this  long  series  of  ex- 
periments, the  patient  had  no  recollection  of  what 
had  passed. 

She  was  asked  then  to  shut  her  eyes,  and  a  pen  was 
given  to  her.  She  was  told  to  try  to  recollect  what 
occurred  when  asleep,  but  she  could  not  remember 
anything.  The  pen  meanwhile  wrote  without  the 
patient's  knowledge  an  account  of  what  had  occurred. 
(See  Figure  4.) 


vV^ 


CHAPTER  V 

SUBCONSCIOUS    EXPERIENCES 

A  series  of  experiments  was  then  carried  on  in  the 
same  line  demonstrating  the  same  truth,  namely,  the 
presence  of  experiences  of  which  the  patient  was  not 
directly  cognizant,  but  which  were  nevertheless  present 
to  the  patient's  subconsciousness.  In  other  words, 
the  experiences  existed  in  a  state  more  or  less  dis- 
sociated from  the  stream  of  mental  life  that  for  the 
time  being  constituted  the  patient's  personal  con- 
sciousness. 

She  was  hypnotized  by  Dr.  W.  and  it  was  sug- 
gested to  her  that  she  could  not  see  Dr.  S.  or 
Dr.  G.  When  Dr.  G.  pricked  the  sole  of  her  foot 
she  said  she  did  not  feel  it,  but  occasionally  there 
was  slight  transient  dilatation  of  the  pupil.  She 
was  then  told  that  when  Dr.  S.  touched  her  and 
knocked  she  would  count,  but  that  she  could  not 
hear  the  knock  or  feel  the  touch.  She  counted 
when  Dr.  S.  touched  her  and  knocked,  but  not 
unless  these  two  signals  went  together.  When  Dr. 
G.  touched  her  and  Dr.  S.  knocked,  she  said 
nothing. 

Dr.  S.  and  Dr.  G.,  neither  of  whom  she  could  see 

60 


Subconscious  Experiences  61 

or  hear,  talked  to  her  and  said  funny  things  ;   she 
laughed,  but  said  she  heard  nothing. 

Hyperesthesia  of  smell,  which  is  sometimes  char- 
acteristic of  the  hypnotic  state  in  the  deepest  stages, 
was  tested.  Drs.  W.,  S.,  and  G.  each  took  a  sheet  of 
paper  and  held  it  in  their  hands  until  it  was  well 
warmed,  then  the  subject  was  asked  to  smell  of  each 
of  their  hands  and  try  and  pick  out  the  piece  of  paper 
belonging  to  each  ;  several  tests  were  made  ;  with  the 
exception  of  two  cases  the  patient  uniformly  failed. 

An  experiment  was  then  made  in  which  it  was 
attempted  to  bring  together  the  experiences  dis- 
sociated from  the  patient's  consciousness  and  those 
that  constituted  the  normal  stream  of  her  personal  life. 
The  patient  did  not  see  any  one  in  the  room  with  the 
exception  of  Dr.  W.  The  experiment  consisted  in 
putting  the  patient  into  a  strange,  unusual  emotional 
state,  and  observing  whether  she  would  then  see  the 
other  persons  in  the  room.  This  was  done  in  the  fol- 
lowing way  : 

Dr.  G.  went  out,  and  in  a  few  moments  came  back 
hurriedly,  saying  Dr.  W.  had  just  been  telephoned  for 
to  come  at  once  to  Fiftieth  Street.  Dr.  W.  put  on 
his  hat  and  coat  and  started  off,  and  Drs.  S.  and  G. 
commenced  making  preparations  to  go  also.  The 
subject  at  first  did  nothing,  but  as  the  doctors  began  to 
leave  she  got  progressively  more  and  more  disturbed, 
and  finally  put  on  her  things,  took  umbrella  and 
nurse's  coat,  and  went  with  Dr.  G.  and  Dr.  S.     When 


62  Psychopathological  Researches 

asked  at  this  time  if  she  saw  Dr.  S.,  she  said  "Yes" 
in  a  faint,  hesitating  voice.  Drs.  S.  and  G.  met  Dr. 
W.  in  the  hall  and  all  came  back  to  the  laboratory. 
The  subject  was  then  asked  if  she  could  see  Dr.  S.; 
she  answered  "  No."  Asked  why  she  had  her  hat 
and  coat  on,  she  could  give  no  explanation.  She  was 
awakened  after  the  suggestion  that  she  would  feel 
well  and  sleep  well  at  night.  She  had  no  memory  of 
what  had  transpired. 

From  this  experiment  we  may  infer  that  the  patient 
could  by  a  strong  emotion  be  brought  out,  tempora- 
rily at  least,  from  her  hypnotic  state  and  a  synthesis 
of  the  dissociated  subconscious  systems  could  take 
place.  It  is  highly  improbable  that  she  was  during 
this  time  in  her  full  waking  state.  This  could  be 
more  or  less  seen  from  the  way  in  which  she  acted, 
and  also  from  the  expression  of  her  face.  She  was  in 
a  dazed  condition,  looking  as  if  stupefied  and  stunned 
by  the  unexpected  experiences.  Furthermore,  all 
memory  was  gone  after  she  was  awakened.  This 
seems  to  indicate  that  the  patient  was  really  not 
in  her  normal  waking  state,  although  she  seemed  to 
have  emerged  from  her  habitual  hypnotic  condition. 
It  is  more  probable  that  a  new  state  was  formed,  dif- 
ferent both  from  her  waking  and  her  habitual  hyp- 
notic state. 

What  this  experiment  really  does  show  clearly  is 
the  fact  that  the  patient  does  perceive  subconsciously 
stimuli  which  apparently  do  not  reach  her  narrowed 


r 


64  Psychopathological  Researches 

field  of  consciousness.  These  stimuli,  under  special 
conditions,  such,  for  instance,  as  a  strong  emotion, 
may  bring  about  a  total  change  in  the  relations  of  the 
different  systems  of  the  patient's  consciousness  and 
result  in  a  different  mental  state.  Experiences  dis- 
sociated and  apparently  unperceived  will  now  become 
associated  and  synthetized  in  the  newly  formed  men- 
tal state.  The  induced  emotional  state  did  not  bring 
the  patient  to  the  original  normal  waking  state. 

On  awaking  it  was  found,  as  pointed  out,  that 
the  patient  had  lost  all  memory  as  to  what  had 
happened.  To  show,  however,  that  the  memories 
were  really  present  and  not  utterly  lost,  and  under 
certain  conditions  could  be  brought  to  light,  the  fol- 
lowing experiments  were  made  : 

The  patient  was  now  set  down  to  a  table  with  a 
pen  in  her  hand  and  with  her  eyes  closed  ;  she  was 
asked  to  try  and  recall  what  had  happened  while 
asleep,  but  told  to  keep  her  hands  quiet.  She  pro- 
tested that  she  could  think  of  nothing,  but  the  hand 
wrote  an  account  of  the  experiences  she  had  just 
passed  through.     (See  Figures  5,  6,  7,  and  8.) 


CHAPTER  VI 

SUBCONSCIOUS    MOTOR    MANIFESTATIONS 

Pneumographs  tracings  were  taken  of  the  patient, 
first  in  the  waking  state  without  any  stimulation, 
then  she  was  hypnotized  and  the  pneumographic 
tracings  were  continued  during  hypnotization  and 
the  deep  hypnosis  into  which  she  passed.  The 
patient  was  as  usual  en  rapport  only  with  Dr.  W., 
to  whom  she  was  used  and  who  had  habitually 
hypnotized  her.  All  other  persons  in  the  room 
were  simply  so  many  negative  quantities  to  her, 
she  apparently  did  not  perceive  anything  which  came 
from  them,  and  as  usual  appeared  to  be  unconscious 
to  pain,  touch,  and  other  stimuli  coming  from  them. 
The  pneumographic  tracings,  however,  clearly  indi- 
cate that,  although  she  was  seemingly  unconscious  of 
different  stimuli  coming  from  other  persons,  her  res- 
piration responded  to  them.  Thus,  for  instance,  in 
tracing  4,  Plate  III.,  a  person  who  was  negative 
to  the  patient  was  tickling  the  sole  of  her  foot. 
The  patient  was  not  conscious  of  the  tickling  and 
still  the  pneumograph  clearly  showed  a  great  modifi- 
cation in  the  respiration,  the  waves  becoming  more 
rapid  and   the  apices   more  acute,   showing  a   rapid 

s  65 


66  Psychopathological  Researches 

alternation  of  inspiration  and  expiration.  Although 
she  apparently  did  not  hear  Dr.  G.,  still  when  he  was 
telling  stories  to  her  there  was  a  great  modification 
in  her  respiration. 

Experiments  were  then  carried  on  by  the  method 
of  distraction.  These  experiments  point  in  the  same 
direction,  viz.,  the  subconscious  presence  of  experi- 
ences of  which  the  patient  was  directly  unconscious. 
The  method  of  distraction  consists  in  the  following : 
The  patient's  mind  is  occupied  with  some  stimuli  that 
fully  engross  the  mind  and  meanwhile  some  slight 
stimulus,  faintly  perceptible,  is  given,  a  stimulus  of 
which  the  patient  is  unconscious,  and  it  is  found  out 
whether  the  patient  perceives  it  in  a  subconscious  form. 
In  other  words,  arrangements  are  made  to  the  effect  of 
discovering  whether  the  subconscious  systems,  dis- 
sociated from  the  general  stream  of  the  patient's  per- 
sonal consciousness,  have  perceived  the  stimulus  and 
reacted  to  it  in  response.  During  the  experiments 
conducted  by  this  method  of  distraction,  this  patient 
was  not  hypnotized. 

The  pneumograph  was  attached  and  the  following 
series  of  experiments  were  made  : 

During  hypnosis,  suggestion  was  made  that  when 
awake,  when  she  heard  Dr.  W.  knock,  she  would  go 
to  sleep.  She  was  awakened  and  placed  in  distraction 
by  reading.  When  Dr.  S.  knocked,  no  result ;  when 
Dr.  W.  knocked,  she  immediately  went  into  hypnosis. 

She  was  hypnotized   and  a  post-hypnotic  sugges- 


V 


Subconscious  Motor  Manifestations        67 

tion  given  to  her  that  she  should  go  to  sleep  when 
Dr.  W.  whistled.  Awakened  by  Dr.  W.  counting, 
and  told  that  she  would  awake  at  a  certain  number. 
Then  distracted  by  reading.  Dr.  W.  went  to  farther 
end  of  the  room  and  whistled.  She  immediately  went 
to  sleep. 

During  these  experiments  taken  with  sound  stimuli, 
pneumographic  tracings  were  taken,  as  shown  in  Plate 
IV. 


CHAPTER  VII 

THE    PSYCHOPATHIC    PARADOX 

Experiments  were  then  carried  out  in  which  the 
sesthesiometer  was  used.  At  first  the  sensibility  of 
different  parts  of  the  body  was  determined  in  the 
normal  state.  Afterwards  the  same  was  tried  under 
distraction,  the  patient  writing  down  by  means  of  auto- 
matic handwriting  whether  she  felt  one  or  two  points. 
Now  it  is  interesting  to  find  that  although  the  patient 


V 


wo 


FIGURE  9. 

under  distraction  did  not  seem  to  feel  the  touch 
stimuli,  she  still  gave  correct  answers  and  her  sensi- 
bility was  much  enhanced.  (Figure  9.)  Thus,  for 
instance,  on  the  back  of  the  left  hand  in  the  normal 
state  her  sensibility  was  30  mm.,  while  under  distrac- 
tion the  threshold  of  sensibility  fell  to  19  mm.  With 
the  general  fatigue  of  the  patient,  the  threshold  be- 
came higher  for  both  the  normal  state  and  the  state 
of  distraction.      From   our  standpoint  these  experi- 

68 


d 


70  Psychopathological  Researches 

ments  are  interesting,  because  they  show  that  the 
dissociated  subconscious  systems  may  prove  more 
sensitive  and  have  a  lower  threshold  than  the  ones 
which  constitute  the  patient's  personal  consciousness. 

The  same  method  was  also  employed  with  light 
stimuli.  In  this  particular  instance,  the  interest  and 
value  of  the  experiments  are  very  great,  because,  as 
we  have  pointed  out,  the  patient  was  suffering  from 
a  great  contraction  of  the  field  of  vision,  a  contrac- 
tion so  persistent  that  it  did  not  yield  to  any  hypnotic 
suggestion.  The  patient's  field  of  vision  was  very 
narrow,  as  shown  in  cut  on  page  69.  (Figure  10.) 
Minimum,  150  ;  maximum,  250. 

Patient  was  put  in  the  hypnotic  state  and  a  post- 
hypnotic suggestion  was  given  to  her  that  when  she 
saw  a  light  she  should  fall  asleep.  Awakened  by 
counting  as  before.  Distraction  by  reading.  Dr.  S. 
places  light  at  900  from  direction  of  vision  and  she 
goes  to  sleep.  The  patient  evidently  saw  the  light  at 
900,  although  her  field  of  vision  was  contracted  to 
maximum  250. 

The  same  experiment  under  distraction  was  then 
tried  with  colored  lights,  and  with  the  same  results, 
clearly  revealing  the  fact  that  the  subconscious  field 
of  vision  was  more  extensive  than  the  one  present  to 
the  patient's  personal  consciousness.  The  patient 
was  put  into  the  hypnotic  state  and  a  post-hyp- 
notic suggestion  was  given  to  her  that  she  should 
go  to  sleep  when  she  saw  a  green  light.      Distracted 


The  Psychopathic  Paradox  71 

by  Dr.  S.  talking  to  her ;  a  yellow  light  placed  at  her 
side — no  result ;  a  green  globe  was  put  over  it,  and 
when  she  turned  her  head  so  that  it  came  into  the 
average  normal  field  of  vision  she  went  to  sleep. 
During  these  experiments,  pneumographs  tracings 
were  taken,  and  as  soon  as  the  light,  colored  or  not, 
according  to  the  suggestion,  was  thrown  on  the 
periphery  of  the  retina,  which  was  anaesthetic  to 
light,  she  showed  at  once  reaction  in  respiration  as 
manifested  in  the  pneumographic  curve,  tracings  4 
and  5,  Plate  IV. 

The  interest  here  lies  in  the  fact  that  the  patient, 
in  spite  of  the  contraction  of  the  field  of  vision,  really 
manifested  a  very  extensive  field  of  vision  present 
to  the  subconscious.  Thus,  while  her  retina  was 
anesthetic  and  the  field  of  vision  contracted  for  the 
patient's  personal  consciousness,  there  was  really 
hypercesthesia  and  great  sensitiveness  of  the  sub- 
conscious both  for  light  and  color.  These  experi- 
ments bring  out  clearly  the  nature  of  psychopathic 
anaesthesia,  as  expressed  in  the  so-called  "psycho- 
pathic paradox  "  :  Psychopathic  anesthesia  is  also  hy- 
peresthesia. 


CHAPTER  VIII 

MEMORY   AND  INTELLIGENCE   OF  THE  SUBCONSCIOUS 

The  memory  and  intelligence  of  the  dissociated 
subconscious  systems  are  fairly  well  illustrated  in 
the  following  experiments: 

Patient  was  put  in  the  hypnotic  state  and  a  post- 
hypnotic suggestion  given  to  her  to  fall  into  hypnosis 
when  Dr.  W.  counted  to  a  certain  number.  Awakened 
by  counting.  Distraction  by  reading.  Dr.  W.  stood 
back  of  her  and  counted  ;  when  he  got  to  the  right 
number  she  immediately  fell  into  hypnosis.  She  was 
again  hypnotized  and  a  post-hypnotic  suggestion  given 
to  her  that  Dr.  W.  will  repeat  a  number  of  names  to 
her,  and  when  he  says  the  same  name  twice  she  will 
at  once  fall  into  hypnosis.  Awakened  by  counting. 
Distraction  by  reading.  Dr.  W.  talks  to  her  and 
tells  her  to  raise  her  hand  and  arm  in  the  air,  and  ad- 
just the  book  in  her  hand,  Dr.  W.  standing  behind 
her  and  speaking  in  a  low  tone.  When  the  reading 
stopped  she  did  not  know  that  any  one  had  spoken 
to  her  or  why  her  hand  was  in  the  air.  Distraction 
again  by  reading.  Dr.  W.  calls  out  names,  repeats 
one  without  effect  —  then  repeats  first  name  called 
and   she  falls  into  hypnosis.      In  hypnosis  she  could 

72 


Intelligence  of  the  Subconscious  73 

tell  several  of  the  names  and  the  one  which  produced 
hypnosis.  Says  she  fell  into  hypnosis  because  she 
could  not  help  it. 

Again  hypnotized.  A  post-hypnotic  suggestion 
was  given  that  Dr.  W.  would  call  out  names  and 
when  he  pronounced  the  name  of  a  girl,  she  would 
fall  into  hypnosis.  Awakened  by  counting.  Dis- 
traction by  reading.  Dr.  W.  calls  names  behind 
her  in  low  tone  and  when  he  pronounces  a  girl's 
name  she  immediately  falls  into  hypnosis. 

The  intelligence  of  the  dissociated  subconscious 
systems  can  be  clearly  seen  from  the  fact  that 
they  were  able  to  identify  names,  to  recognize  the 
name  when  repeated,  and  to  discriminate  between 
the  name  of  male  and  female.  All  this  is  done  by 
the  subconscious  while  the  patient's  principal  personal 
consciousness  is  ignorant  of  what  is  going  on.  The 
patient  was  unable  to  tell  during  the  post-hypnotic 
waking  state  what  had  been  whispered  to  her  while 
in  the  condition  of  distraction.  By  no  means  was 
she  able  to  bring  to  memory  the  faintest  trace  left  by 
the  external  stimulus.  To  all  intents  and  purposes 
it  seemed  as  if  she  did  not  hear  and  could  not  there- 
fore recollect.  She  really  did  not  perceive  the  ex- 
ternal stimulus,  but  the  subconscious  systems  did. 
The  external  impression  did  not  reach  the  patient's 
contracted  personal  consciousness,  but  did  reach 
and  remain  within  the  subconscious  regions  of  her 
mental  life.       It  was  due  to  the  perception    by  the 


74  Psychopathological  Researches 

subconscious  systems  that  a  discrimination  of  the 
stimuli  was  performed  and  a  corresponding  reaction 
was  brought  about  in  response. 

The  intelligence  of  the  subconscious  was  still  further 
shown  by  the  fact  that  a  suggestion  was  made  in  the 
hypnotic  state  that  when  she  awoke  and  Dr.  W.  made 
a  number  of  calculations,  she  should  go  to  sleep  at 
a  correct  one,  but  no  matter  how  many  wrong  ones 
were  made,  she  should  pay  no  attention  to  them.  She 
was  awakened  and  as  usual  was  completely  amnesic 
to  what  had  occurred  in  the  hypnotic  state.  We 
used  as  before  the  method  of  distraction.  As  long 
as  Dr.  W.  was  whispering  wrong  calculations,  there 
was  no  reaction,  but  as  soon  as  a  correct  one  was 
given,  she  immediately  fell  into   the   hypnotic  state. 

Here  the  patient  did  not  perceive  directly  the 
scarcely  audible  acoustic  stimuli,  but  the  subconscious 
did,  and  not  only  did  perceive  the  acoustic  stimuli, 
but  also  knew  their  meaning,  recognized  them,  and 
was  so  highly  intelligent  as  to  discriminate  between 
the  wrong  and  right  results,  showing  memory  by  re- 
acting in  the  prearranged  form  to  the  right  calcula- 
tion. 

During  the  time  we  carried  on  these  experiments 
testing  the  memory,  recognition,  and  discrimination 
of  the  dissociated  subconscious,  tracings  were  taken 
with  the  pneumograph  and  each  time  she  was  awak- 
ened by  counting.  The  pneumographic  tracings  re- 
vealed disturbances  to  stimuli  of  which   the  patient 


Intelligence  of  the  Subconscious  75 

was  not  conscious,  but  which,  nevertheless,  effected 
and  called  out  psychomotor  disturbances  of  the  dis- 
sociated subconscious  regions.  (Tracings  1  and  2, 
Plate  V.) 


CHAPTER   IX 

SUBCONSCIOUS    HABIT    FORMATION 

To  test  further  the  intelligence  of  the  subconscious 
and  also  the  formation  of  new  habits,  the  patient  was 
put  into  the  hypnotic  state,  and  it  was  suggested 
that  she  would  awaken  when  ten  was  reached  by 
counting.  When  Dr.  W.  began  to  count,  the  pneu- 
mograph showed  a  marked  disturbance  at  five.  The 
patient  had  formed  a  habit,  from  previous  suggestions, 
to  awake  when  five  was  counted.  Calculations  were 
carried  on  during  the  same  time  to  test  the  patient's 
subconscious  discrimination.  During  the  time  of  the 
waking  state  as  usual  she  reacted  only  to  the  right 
answer,  and  fell  into  the  hypnotic  state  at  once  as 
soon  as  the  correct  result  was  given. 

To  show  how  quickly  the  subconscious  forms  habits, 
in  the  next  experiment  the  suggestion  was  given  her 
that  she  wake  up  when  fifteen  was  reached.  The 
pneumograph  showed  disturbances  at  the  regular 
intervals  of  five  and  ten  —  the  numbers  at  which  she 
had  been  previously  awakened.  Experiments  were 
then  continued  in  the  same  line  by  the  method  of  dis- 
traction, and  the  appreciation  of  the  beautiful  by  the 
subconscious  was  tested.      Along  with  these  experi- 

76 


Subconscious  Habit  Formation  77 

ments  were  also  given  suggestions  while  in  the  hypnotic 
state  to  wake  up  at  various  numbers,  all  of  which  were 
multiples  of  five.  It  was  interesting  to  observe  that 
while  there  were  disturbances  when  a  picture  was 
shown,  and  also  when  the  patient  passed  into  the 
hypnotic  state,  there  were  marked  disturbances  in  the 
respirations  shown  by  the  pneumographic  tracings 
when  the  patient  was  in  the  process  of  being  awak- 
ened on  hearing  counting.  The  patient's  respiration 
was  in  accord  with  each  number  pronounced,  so  that 
there  were  as  many  respiratory  acts  as  there  were 
counts,  and  when  the  counting  reached  five,  ten, 
fifteen,  multiples  of  five,  there  was  a  marked  dis- 
turbance. Thus,  for  instance,  when  it  was  sug- 
gested to  the  patient  that  she  wake  up  when 
thirty  was  reached,  by  counting,  there  were  thirty 
respiratory  acts  and  disturbances  at  five,  ten,  fifteen, 
twenty,  twenty-five,  and  thirty  respectively.     (Plate 

v.) 

The  patient's  subconsciousness  formed  a  habit  to 
react  when  the  number  was  reached  at  which  she  was 
previously  awakened. 

The  following  are  the  specific  experiments  which 
showed  the  conditions  referred  to  above: 

In  the  earlier  experiments  she  had  been  awakened 
by  Dr.  W.  counting  five  or  ten.  Now  he  counted  to 
fifteen  to  awaken  her.  There  was  a  marked  respira- 
tory disturbance  at  ten.  A  post-hypnotic  suggestion 
was  given  her  to  fall  into  hypnosis  when  she  should 


78  Psychopathological  Researches 

hear  a  correct  calculation.  Distraction  by  reading. 
Dr.  W.  makes  calculations  aloud,  and  at  the  first  cor- 
rect one  she  falls  into  hypnosis. 

She  was  again  hypnotized,  and  a  post-hypnotic  sug- 
gestion given  to  her  that  she  would  be  shown  different 
pictures,  and  would  fall  asleep  when  she  saw  a  beauti- 
ful one.  Awakened  by  counting.  Counted  to  twenty 
to  awake.  Pneumograph  showed  respiratory  disturb- 
ances at  five,  ten,  fifteen,  twenty.  (Tracings  4  and  5, 
Plate  V.)  Distraction  by  reading.  Pictures  shown,  and 
she  fell  into  hypnosis  when  one  was  placed  at  her  side. 
It  was  not  pretty.  She  was  asked  to  look  at  it  and 
see  if  it  was  pretty,  but  said  it  was  not.  She  said,  how- 
ever, that  she  fell  into  hypnosis  when  she  saw  a  bright 
picture  (the  former  ones  were  all  black  tracings  ;  this 
was  a  series  of  photographs  on  one  page). 

She  was  again  hypnotized,  and  a  post-hypnotic  sug- 
gestion again  given  to  her  that  she  fall  into  hypnosis 
when  she  saw  a  beautiful  picture.  Awakened  by 
counting  to  twenty-five.  The  pneumograph  showed 
marked  respiratory  disturbances  at  five,  ten,  fifteen, 
twenty,  and  twenty-five.  Distraction  by  reading.  She 
was  shown  pictures,  and  immediately  fell  into  hypnosis 
when  a  beautiful  colored  plate  was  produced.  (Tra- 
cing 5,  Plate  V.) 

She  was  again  hypnotized  and  a  post-hypnotic  sug- 
gestion given  her  to  fall  into  hypnosis  when  she  saw  a 
certain  letter  that  Dr.  W.  would  show  her.  Dr.  W. 
then  counted  thirty  to  awaken  her.     There  were  respi- 


Subconscious  Habit  Formation  79 

ratory  disturbances  at  ten,  twenty,  twenty-five,  and 
thirty.     (Tracing  5,  Plate  V.) 

A  tracing  was  now  taken  while  only  counting  from 
one  to  thirty.  Awakened,  distraction  by  reading. 
Letters  were  shown  her.  She  fell  at  once  into  hypnosis 
when  the  right  one  had  been  shown  twice.  In  hypnosis 
could  repeat  some  of  letters  shown,  but  while  they 
were  being  shown  she  glanced  at  them. 

Again  hypnotized,  and  a  post-hypnotic  suggestion 
given  her  to  fall  into  hypnosis  when  Dr.  W.  would 
show  her  the  name  of  a  man,  and  she  was  told  not  to 
glance  toward  the  names.  Awakened  by  counting 
rapidly  from  one  to  fifty  ;  distraction  by  reading.  The 
names  were  shown,  and  she  fell  into  hypnosis  at  the 
name  of  a  man,  but  persisted  in  glancing  towards  the 
names,  which  were  purposely  held  much  to  one  side. 
(Tracings  6  and  7,  Plate  V.) 

It  was  now  desirable  to  see  what  was  the  influence 
of  mere  counting  in  both  waking  and  hypnotic  states. 

While  the  patient  was  awake,  Dr.  W.  counted  up 
to  ten  ;  then  up  to  fifteen,  and  it  was  found  that  the 
patient's  respiration  was  but  little  affected,  keeping 
pace  in  a  very  irregular  way  with  the  counting.  It 
showed  slight  disturbances  at  five  and  ten. 

The  patient  was  then  put  in  the  hypnotic  state, 
and  the  same  experiments  were  repeated.  The  respi- 
ration kept  more  accurately  in  pace  with  the  counting, 
and  disturbance  was  distinctly  marked  at  multiples 
of  five. 


80  Psychopathological  Researches 

For  these  experiments  see  tracings  r,  2,  and  3, 
Plate  VI. 

Experiments  were  again  made  by  counting  to  awaken 
her,  and  the  disturbances  at  multiples  of  five  were 
marked.      (Tracing  2,  Plate  VI.) 

Experiments  were  further  made  by  counting  to 
produce  hypnosis,  tracings  being  taken  during  the 
process  of  hypnotization.  There  were  no  disturb- 
ances at  the  multiples  of  five.      (Tracing  3,  Plate  VI.) 

Experiments  were  then  made  during  hypnosis  to 
show  the  influence  of  counting  by  a  person  with  whom 
she  was  not  en  rapport.  The  tracings  showed  that 
there  were  regular  intervals  of  respiration  in  accord 
with  the  counting,  and  the  patient  manifested  the 
same  tendency  to  respiratory  disturbances  at  five,  ten, 
etc.  This  counting  was  slow.  Rapid  counting  was 
then  tried  from  one  to  fifty;  the  respiration  was  very 
rapid,  keeping  pace  with  the  counts.  Further  experi- 
ments were  varied,  counting  slow  and  fast  from  one  to 
ten  and  from  one  to  fifty,  and  in  all  of  them  the  patient 
clearly  manifested  a  tendency  to  keep  pace  in  her 
respiration  with  the  counts  of  Dr.  S.,  with  whom  she 
was  not  en  rapport  and  whom  apparently  she  did  not 
hear.  When  the  counting  was  very  fast  there  was  no 
marked  disturbance  at  multiples  of  five  ;  it  became 
manifest,  however,  as  soon  as  the  rate  of  counting 
became  slower.     (Tracings  3  and  4,  Plate  VI.) 

When  the  fast  counting  was  stopped  suddenly, 
there  was  also  a  sudden  marked  stop  of  the  respira- 


Subconscious  Habit  Formation  81 

tion.  These  last,  disturbances  can  be  clearly  seen  in 
tracings  5,  6,  and  7,  Plate  VI.  The  regularity  of 
keeping  pace  with  rhythmical  sounds  was  especially 
well  manifested  when  the  metronome  was  used,  the 
respirations  keeping  pace  with  the  beats  of  the  metro- 
nome.    (Tracing  7,  Plate  VI.) 

The  subconscious  forms  habits  easily  which  are  as 
easily  broken.  In  fact,  in  the  remarkable  plasticity 
of  the  subconscious,  in  the  great  ease  of  subconscious 
habit  formation,  lies  the  secret  of  hypnotic  suggestion. 
Once  a  habit  has  been  subconsciously  formed  and 
permitted  to  persist  and  develop,  it  is  very  difficult 
to  eradicate  it.  It  is,  however,  nigh  impossible  to 
eradicate  the  habit  of  personality  suggestion  or  so- 
called  "rapport,"  if  it  is  permitted  to  be  formed, 
and  herein  lies  the  danger  of  suggestion,  whether  in 
the  waking  or  hypnotic  state.  Thus  it  was  impossible 
to  change  the  subconscious  habits  formed  by  the 
patient  in  their  relation  to  Dr.  W.,  who  had  been  ex- 
perimenting with  her  since  her  entrance  into  the  hos- 
pital, and  with  whom  she  had  formed  the  habit  of 
standing  en  rapport  during  hypnosis.  It  was  attempted 
to  have  her  awakened  from  the  hypnotic  sleep  by  a 
person  other  than  Dr.  W.,  and  by  one  with  whom  she 
was  not  en  rapport,  but  to  whom  she  was  nevertheless 
habituated  by  a  long  series  of  experiments,  viz.,  Dr. 
S.  The  results  showed  that  the  hypnotic  memory 
was  so  persistent  that  it  was  impossible  to  overcome 
it  by  the  ordinary  suggestions  coming  from  a  source 


82  Psychopathological  Researches 

with  which  she  had  not  formed  the  habit  of  being  en 
rapport.  Thus,  in  one  of  her  hypnotic  states,  Dr.  S. 
made  an  attempt  to  have  her  count  to  ten  and  awaken. 
She  positively  refused  to  wake  up,  saying  that  she 
could  not  wake  up  because  he  had  not  hypnotized  her. 
Dr.  W.  suggested  to  her  that  on  awaking  she 
should  allow  Dr.  S.  to  hypnotize  her.  Dr.  W.  awoke 
her  and  Dr.  S.  hypnotized  her.  Dr.  S.  made  a  sug- 
gestion to  her  that  she  could  not  hear  Dr.  W.,  but 
she  did  not  take  the  suggestion;  she  answered  Dr. 
W.  each  time  he  spoke  to  her.  Dr.  S.  made  a  post- 
hypnotic suggestion   that  on  awaking  she  could  not 

yidJ/         jl 

FIGURE  11. 

see  nor  hear  Dr.  W.    He  awoke  her,  but  the  suggestion 
was  not  acted  upon. 

So  strong  was  this  personality  suggestion,  that  in 
one  of  her  automatic  writings  under  distraction,  she 
wrote  spontaneously  the  following  :  "  I  will  do  any 
thing  Dr.  White  (tells)  me  to  (do),"  emphasizing  it 
with  an  affirmative  "  yes  "  ;  and  at  another  time  she 
wrote,  "  and  no  one  else  will  be  able  to  hypnotize  me 
only  Dr.  White."  These  writings  are  reproduced 
above,  Figure  1 1,  and  on  page  97,  Figure  14. 


CHAPTER   X 

SUBCONSCIOUS     RETENTION AUTOMATIC    WRITING    AND 

ANAESTHESIA 

The  patient  was  awakened,  and  by  the  method  of 
automatic  handwriting  it  was  endeavored  to  discover 
whether  all  the  experiences  which  the  patient  did  not 
remember  were  really  retained  in  the  memory  of  the 
subconscious  self. 

Experiments  were  then  made  on  the  patient  by 
means  of  automatic  writing.  The  hand  in  its  auto- 
matic writing  revealed  experiences  which  were  not 
known  to  the  patient  herself.  During  the  automatic 
writing,  the  sensibility  of  the  writing  hand  and  arm 
was  greatly  lessened,  merging  into  anaesthesia.  This 
probably  depends  on  the  fact  that  during  the  writing 
the  consciousness  of  the  sensory-motor  systems  related 
to  the  activity  of  the  hand  is  dissociated  from  the  prin- 
cipal consciousness  and  associated  with  the  active 
subconscious  systems  lying  outside  the  range  of  the 
patient's  personal  life. 

Some  examples  of  the  patient's  automatic  hand- 
writings, with  eyes  shut  trying  to  recall  what  happened 
during  hypnosis,  are  reproduced  in  Figures  4,  5,  6,  7, 
and  8. 

83 


84  Psychopathological  Researches 

During  the  writing,  the  hand  was  being  pricked  by 
Dr.  S.,  but  when  the  patient  was  questioned  she 
claimed  she  had  not  felt  it. 

Automatic  handwriting  at  dictation  from  Dr.  W., 
while  being  distracted  by  Dr.  G.  talking  to  her.  The 
writing  hand  was  being  pricked  by  Dr.  S.  At  one 
time,  entire  writing  arm  was  anaesthetic  to  the 
shoulder,  so  that  she  had  no  knowledge  of  the  prick- 
ing. At  another  time  the  pricking  of  either  arm  or 
hand  disturbed  her,  and  she  recollected  it  on  being 
questioned  about  it  later.  Pricking  the  writing  arm 
was  recollected  when  the  pricking  was  in  the  intervals 
of  the  writing.  The  disturbance  of  arm  and  hand 
by  pricking  was  much  more  noticeable  when  the 
writing  was  not  continuous,  when  there  were  many 
intervals. 

Experiments  in  automatic  handwriting  and  dis- 
traction were  continued  and  the  sensibility  of  the 
writing  hand  and  arm  tested  with  the  following  results  : 

Under  distraction  ;  right  hand.  At  beginning  the 
sensibility  to  electricity  during  writing  was  dulled, 
especially  in  the  hand,  but  later  the  hand  became 
very  sensitive,  and  reacted  at  once,  feeling  the  stimu- 
lus every  time  she  was  touched  by  the  electrodes 
during  the  writing.  The  same  results  occurred  in  the 
left  hand. 

Instead  of  electricity,  a  pin-point  was  then  used, 
and  she  mistook  the  prick  for  electricity.  When  the 
prick  was  repeated  and  she  was  asked  if  that  was 
what  she  had  felt,  she  said  :  "  No,  it  was  electricity." 


Subconscious  Retention  85 

Dr.  S.  then  gave  suggestions  during  distraction, 
but  later  she  stopped  taking  his  suggestions  ;  at  first 
when  her  eyes  were  closed  and  later  when  they  were 
open. 

The  patient  afterwards  continued  to  react  to  prick- 
ing, although  she  said  she  did  not  feel  it.  When 
pricked,  she  often  said  she  did  not  feel  it,  but  wrote 
in  answer  to  questions  by  Dr.  W.  the  number  of 
times  pricked.  The  written  answer  of  one  of  these 
tests  is  reproduced  on  page  59,  Figure  7. 

The  experiments  carried  on  by  automatic  hand- 
writing, and  the  anaesthesia  manifested,  seem  to  indi- 
cate that  although  the  dissociation  was  more  or  less 
profound,  it  was  rather  of  a  transitory  character,  and 
under  the  influence  of  a  strong  stimulus  —  such,  for  in- 
stance, as  electricity,  when  reaching  a  high  intensity  — 
the  anaesthesia  disappeared  not  only  during  the  inter- 
vals when  the  patient  did  not  write,  but  also  during  the 
process  of  writing  itself.  In  short,  we  may  say  that 
functional  anaesthesia,  when  slight  and  transitory,  as  is 
usually  the  case  in  automatic  handwriting,  can  be 
made  to  disappear  under  the  influence  of  strong  pain- 
ful or  disagreeable  stimuli.  The  anaesthesia  recurs, 
however,  more  markedly  than  before  with  the  ces- 
sation of  the  stimuli,  and  with  the  re-establishment  of 
conditions  favorable  to  it.  This  is  probably  analogous 
to  the  condition  of  negative  hallucination,  or  system- 
atic anaesthesia,  in  which  the  patient  is  insensible  to 
stimuli   proceeding   from  a   certain  source.     In  this 


86  Psychopathological  Researches 

latter  condition,  we  have  pointed  out  before  by  experi- 
ment, that  the  negative  hallucination,  or  anaesthesia, 
may  disappear  under  the  influence  of  a  strong  emotion. 
An  intense  or  a  strong  emotion  may  call  forth  in  the 
patient  static  energy,1  and  thus  enable  her  to  carry 
on  the  particular  functions  lost,  and  with  the  removal 
of  the  stimuli  and  the  drawing  off  of  the  static  energy 
manifested,  the  patient  may  fall  into  a  deeper  psycho- 
pathic state. 

1  See  "  Neuron  Energy,"  Archives  of  Neurology  and  Psychopathology,  vol.  i., 
No.  I. 


CHAPTER  XI 

SUGGESTIBILITY    IN    THE  WAKING    STATE 

Experiments  were  then  made  on  the  patient  to 
test  her  suggestibility  in  the  waking  state. 

For  the  purposes  of  these  experiments  a  pack  of 
ordinary  playing  cards  was  used,  and  it  was  endeavored 
to  discover  whether,  when  the  patient  was  requested 
to  make  a  voluntary  choice  of  one  of  them,  she  could 
be  so  influenced  by  indirect  suggestion  as  to  choose  a 
card  previously  determined  on  by  the  experimenter. 

The  artifices  used  for  making  the  suggestion  were 
numerous ;  for  instance,  the  cards  were  partially 
separated  and  held  face  up,  some  one  of  them,  how- 
ever, being  so  placed  that  it  could  be  more  readily 
seen,  then  the  entire  pack  was  passed  rapidly  before 
the  patient's  eyes,  and  she  was  asked  to  make  a 
choice.  She  invariably  chose  this  most  prominent 
card.  If,  again,  the  card  to  be  chosen  was  placed  so 
as  to  be  surrounded  by  others  of  a  different  color — for 
instance,  a  red  card  with  two  black  ones  on  either 
side, — and  she  was  again  asked  to  choose,  the  red  card 
would  be  chosen.  Again,  if  the  experimenter  took  a 
few  cards,  face  up,  in  his  left  hand,  and  then  with  the 
right  hand  picked  them  up  separately  and  dropped 

87 


88  Psychopathological  Researches 

them  on  the  table,  the  patient  meanwhile  being  asked 
to  watch  the  cards  closely  and  choose  one  of  them,  it 
was  found  that  if  in  this  process  the  rhythm  of  the 
motions  used  was  disturbed  at  any  particular  card,  or 
one  of  the  cards  was  thrown  beyond  the  others,  or 
rotated  in  being  dropped  to  the  table,  or,  again,  if  a 
card  was  both  preceded  and  followed  by  cards  of  a 
different  color,  the  card  so  peculiarly  dealt  with  or 
located  was  the  one  chosen.  Again,  several  cards 
were  placed  upon  the  table,  one  at  a  time,  by  the 
experimeter,  and  the  patient  asked  to  choose  one 
of  them  after  they  were  all  deposited  ;  if,  now,  the 
experimenter  moved  his  hand  over  the  cards  to 
straighten  or  rearrange  them,  any  lingering  over  any 
particular  card,  or  any  motion  imparted  to  one  card 
different  from  that  given  the  others,  resulted  in  the 
choice  of  that  card.  In  short,  any  method  employed 
by  which  one  card  was  rendered  more  or  less  different 
from  the  others,  either  by  virtue  of  its  relative  loca- 
tion, or  by  virtue  of  motions  imparted  to  it,  or  by 
virtue  of  its  peculiar  position  relative  to  other  cards 
of  other  colors,  always  resulted  in  the  choice  of  that 
card.  It  was  noted,  however,  that  where  the  distinc- 
tion was  very  slight,  or  the  whole  process  exceedingly 
complicated  and  prolonged,  the  suggestion  frequently 
failed.  It  seemed  as  if  the  subconscious  had  to 
understand  clearly  and  distinctly  what  was  required 
of  it,  so  that  when  the  conditions  were  such  as 
not  to  bring  out  clearly  the  intentions  of  the  experi- 


Suggestibility  in  the  Waking  State        89 

menter,  or  when  they  became  very  complicated  so  as 
to  give  different  interpretations  to  the  experimenter's 
suggestions,  the  suggestion  did  not  succeed. 

A  pair  of  shears  was  laid  on  the  floor.  D.  F.  was 
standing  on  one  side  of  them,  and  facing  Dr.  W.,  who 
stood  on  the  opposite  side.  Dr.  W.  held  up  his  hand 
and  told  her  that  she  could  not  step  over  the  shears, 
and  told  her  to  advance.  She  walked  as  far  as  the 
shears,  but  was  unable  to  go  farther. 

Dr.  S.  told  her  she  could  not  pronounce  her  own 
name  ;  at  first  she  did,  but  on  repeated  suggestion  she 
failed  to  do  it.  When  told  she  would  stammer,  she 
did  so. 

Dr.  S.  suggested  to  her  that  she  could  not  write 
her  name,  and  when  challenged  to  do  so,  she  failed. 


CHAPTER  XII 

SYNTHESIS    OF    DISSOCIATED    SUBCONSCIOUS    SYSTEMS 

An  attempt  was  now  made  to  run  together  the  pa- 
tient's dissociated  mental  systems.  As  it  was  pointed 
out  before,  suggestions  given  to  the  patient  during 
hypnosis  could  not  bring  about  a  permanent  effect 
of  synthesis.  The  patient  could  not  be  suggested  in 
the  waking  state,  nor  was  it  possible  to  give  her  any 
permanent  suggestion  by  the  method  of  distraction, 
nor  by  the  method  of  automatic  writing  in  a  manner 
that  could  bring  about  a  satisfactory  result.  One  can 
easily  see  the  reason  why  it  is  impossible  to  effect  by 
means  of  suggestion  an  association  of  a  disaggregated 
consciousness,  when  the  patient  is  in  the  state  of 
distraction,  or  when  the  patient  is  carrying  on  auto- 
matic writing,  or  when  in  a  state  of  hypnosis,  be- 
cause any  of  these  conditions  are  themselves  states  of 
dissociation  that  have  not  the  power,  or  rather  the 
possibility,  of  effecting  a  synthesis  with  states  from 
which  they  are  dissociated.  It  would  not  do  to 
address  oneself  to  a  dissociated  state  to  effect  a  syn- 
thesis. In  the  case  of  the  hypnotic  condition,  it  is 
true,  all  the  states  are  more  or  less  present,  and  a  sug- 
gestion, if  it  be  emphatic  enough,  might  effect  some 

90 


Synthesis  of  Dissociated  Systems         91 

result.  If,  however,  we  consider  the  fact  that  hypnosis 
itself  presents  a  state  of  high  psychophysiological 
plasticity,  that  in  this  state  systems  are  not  very 
stably  organized,  are  continually  shifting  in  their  as- 
sociations and  dissociations,  we  can  see  the  reason 
why  suggestion  in  hypnosis  can  not  possibly  give 
permanent  results.  What  then  shall  be  our  course  ? 
How  can  we  bring  about  an  association  of  disag- 
gregated systems  so  that  the  synthesis  shall  be  of 
a  lasting  character  ?  Evidently,  the  synthesis  must 
take  place  in  a  state  in  which  the  dissociated  sys- 
tems are  all  present,  and  which  is  not  of  the  plas- 
tic hypnotic  character.  In  other  words,  we  must 
put  the  patient  in  a  state  in  which  she  herself  shall 
have  control  of  her  experiences.  In  short,  the 
patient  must  be  put  in  a  more  or  less  normal  condi- 
tion. But  this  condition  must  be  of  such  a  character 
as  to  make  possible  an  access  to  the  patient's  con- 
sciousness. This  intermediary  state  must  there- 
fore be  a  sort  of  mental  ground  on  which  the  dis- 
sociated systems  may  meet,  be  balanced,  controlled 
by  the  patient's  own  activity.  The  nearest  approach 
to  it  can  be  found  in  normal  sleep.  Not  exactly  in 
the  deep  normal  sleep  where  functional  activity  al- 
together ceases,  but  in  those  sleeping  dream  states, 
when  one  begins  to  emerge  from  the  deep  levels  of 
sleep,  and  is  on  the  way  to  pass  into  the  waking  state. 
It  is  the  borderland  between  the  sleeping  and  waking 
condition.     Our  course  was  in  accordance  with  this 


9 2  Psychopathological  Researches 

general  plan.  We  attempted  to  put  the  patient  into 
a  normal  sleeping  stale,  and  in  order  to  be  in  touch 
with  the  patient  during  this  condition,  this  sleeping 
state  was  approached  through  the  induction  of 
hypnosis.  The  patient  was  hypnotized,  and  it  was 
suggested  to  her  that  when  the  pneumograph  was  at- 
tached to  her  and  ready  for  use  she  would  fall  into 
a  natural  sleep.  This  she  did.  When  spoken  to  by 
Dr.  S.  or  Dr.  W.,  she  did  not  answer. 

Pneumographic  tracings  were  taken  during  sleep. 
(Plates  VII.  and  VIII.) 

Pencil  and  paper  were  given  her  and  she  sponta- 
neously wrote  her  experiences. 

During  this  writing  the  pneumograph  showed  great 
disturbances.  Counting  in  her  presence  produced 
respiratory  disturbances  in  rhythm  with  the  sounds. 

While  the  patient  was  in  this  state  of  sleep,  conver- 
sations were  carried  on  with  her  and  she  was  able  to 
hear  and  feel  all  the  stimuli  given  her.  There  were 
no  systematized  anaesthesias  to  objects  or  persons. 
The  writing  was  carried  out  by  her  voluntarily  and 
spontaneously  and  she  was  fully  conscious  of  what 
she  was  doing. 

Opportunity  was  taken  now  to  bring  together  in  a 
synthesis  the  dissociated  states  of  consciousness,  and 
two  letters  addressed  to  her  mother  were  dictated  to 
her,  one  by  Dr.  W.  and  the  other  by  Dr.  S.  The 
letter  of  Dr.  W.  was  to  the  effect  that  when  any 
one  whispered  to  her  she  would   be   fully  aware  of 


Synthesis  of  Dissociated  Systems         93 

what  was  said,  and  that  she  would  no  longer  write 
unless  she  knew  perfectly  what  she  was  writing. 
(Figure  12.)  The  letter  of  Dr.  S.  was  for  the  pur- 
pose of  arousing  the  energy  and  will  of  the  patient 
and  insisting  on  the  fact  that  she  would  try  and  not 
be  sick  any  more ;  in  short,  that  she  should  make  the 
attempt  to  bring  into  association  the  dissociated  sys- 
tems. (Figure  13.)  It  was  the  awakening  of  the  pa- 
tient's spontaneous  energy  coming  from  the  depths  of 
her  own  being.  That  this  energy  was  really  awakened 
and  the  synthesis  voluntarily  formed  by  the  sponta- 
neous activity  of  the  patient  herself  are  well  shown  in 
the  interesting  and  highly  suggestive  lines  which  she 
herself  volunteered  after  the  letter  was  finished,  as  if 
to  emphasize  distinctly  that  what  she  had  just  written 
by  dictation  was  not  a  matter  of  a  passively  accepted 
suggestion,  but  of  a  spontaneous,  voluntary,  active, 
energetic  resolution.  The  resolution  was  especially 
well  seen  in  the  way  she  wrote  it.  The  pencil  was 
firmly  grasped  in  the  hand,  and  she  wrote  quickly  and 
with  determination  the  following  sentence:  u  I  mean 
what  I  have  just  written"  and  signed  her  name. 
(Figure  14.) 

After  she  wrote  this,  she  was  allowed  to  sleep  for 
some  time  and  finally  was  awakened  by  a  noise  acci- 
dentally made  by  one  of  us  in  dropping  an  object. 
In  addition  to  the  pneumographic  tracings  1  and 
2,  Plate  VII,  which  show  well  the  tracings  of  nor- 
mal sleep    in    contrast   to    those  taken    in  hypnosis, 


Synthesis  of  Dissociated  Systems         95 

there  is  here  also  another  proof  of  the  patient 
being  in  a  state  of  non-hypnotic  normal  sleep  in  the 
way  in  which  she  awoke  spontaneously  by  an  acci- 
dental noise,  which  would  not  have  wakened  her  in 
her  hypnotic  state. 

On  awakening,  all  attempts  at  distraction  by  get- 
ting her  to  read,  and  whispering  behind  her  to  write 
something,  failed.  (Plate  VIII.)  She  did  not  know 
what  she  had  read,  but  heard  everything  said  to  her. 
She  was  then  hypnotized  by  Dr.  W.,  and  an  attempt 
at  distraction  and  automatic  handwriting  again  failed. 

During  hypnosis,  to  reinforce  the  patient's  resolu- 
tion and  formed  synthesis  of  the  dissociated  states, 
she  was  told  that  if  any  one  whispered  to  her  from 
behind,  even  Dr.  W.,  she  would  hear  perfectly  what 
he  said,  also  that  she  would  no  longer  write  unless 
she  knew  what  she  was  writing,  also  that  her  eyesight 
would  be  as  good  as  any  one's,  and  that  she  would 
feel  perfectly  well.  She  was  also  told  that  she  would 
remember  everything  hereafter  that  happened  during 
hypnosis.  She  was  told  she  could  hear  Dr.  S.,  and 
when  he  spoke  to  her  she  heard  him.  She  was  told 
she  could  remember  what  occurred  in  the  natural 
sleep  just  recorded,  and  she  recollected  everything. 

Dr.  W.  then  told  her  he  would  awake  her  by 
counting  slowly  from  1  to  75,  and  that  she  would  get 
more  and  more  awake  as  he  approached  75,  and  wake 
at  75.  Dr.  W.  counted  from  1  to  25  and  repeated 
the  suggestion  as  above,   then  from    26   to    50  and 


98  Psychopathological  Researches 

repeated  the  suggestion  again,  then  from  51  to  70  and 
repeated  it  again,  and  then  from  71  to  75  and  she 
awoke.  On  awakening,  she  remembered  all  that  had 
happened  in  hypnosis,  but  could  not  recollect  what 
had  happened  while  in  normal  sleep.  Dr.  W.  hypno- 
tized her  again  and  told  her  that  on  awaking  she  must 
remember  all  that  had  occurred  in  the  normal  sleep. 
Dr.  W.  then  awoke  her  slowly,  counting  from  1  to 
30,  and  pausing  to  repeat  suggestions  about  distrac- 
tion, automatic  writing,  eyesight  and  health,  etc.,  and 
also  about  remembering  what  happened  while  in  nor- 
mal sleep.  Pauses  to  repeat  these  suggestions  were 
made  at  10,  20,  27,  28,  and  29,  and  she  awoke  at  30 
with  complete  recollection  of  all  that  had  happened 
during  hypnosis  and  natural   sleep. 

Tracings  were  taken  during  the  first,  but  not  the 
last  hypnosis. 

The  field  of  vision,  taken  immediately  after  at- 
tempts to  run  together  the  dissociated  systems  into 
one,  was  markedly  enlarged  (see  Chart,  Figure  15). 
The  field  of  vision  kept  on  expanding.  A  comparison, 
with  a  field  of  vision  taken  eight  days  afterwards, 
showed  that  it  was  still  slightly  contracted.  This 
latter  field  reached  the  limits  of  the  normal  standard 
(see  Chart,  Figure  16).  The  patient  evidently  was 
recuperating  her  energy  slowly.  The  synthetic  pro- 
cess was  going  on  continually,  resulting  in  a  more 
stable,  more  permanent  synthesis  of  the  disaggregated 
systems,  causing  a  loss  of  the  phenomena  of  automatic 


> 


b 


> 


c 


ioo  Psychopathological  Researches 

writing,  subconscious  answers,  and  giving  rise  to  a 
larger  and  more  extensive  field  of  consciousness. 

Eight  days  later,  the  following  extract  from  a  letter, 
sent  by  Dr.  W.  to  Dr.  S.,  gives  an  account  of  the  pa- 
tient's state  and  her  field  of  vision  : 

"  Enclosed  please  find  visual  field  of  D.  F.,  taken 
this  day ' ;  also  a  visual  field  for  comparison,  taken 
on  the  26th  of  June  last.     (Figure  1.) 

"  In  addition,  I  have  made  the  following  experi- 
ment to-day : 

"  Experiment  1. —  Patient  was  placed  at  side  of 
table  and  given  paper  to  read  aloud.  Attempt 
to  distract  her  by  speaking  in  a  low  tone  of  voice 
from  behind  and  requesting  her  to  write  produced 
no  result.  I  also  took  hold  of  her  hand,  placing 
a  pencil  in  it.  When  questioned  afterwards,  was 
able  to  recollect  all  I  had  said  to  her  and  had  felt  me 
touch  her  hand.  An  attempt  afterwards  on  her  part 
to  both  read  aloud  and  write  her  name  at  the  same 
time  proved  her  inability  to  do  it. 

"  Experiment  2. — Hypnosis  ;  eyes  shut.  I  spoke 
to  her  several  times  ;  Mrs.  S.,  who  was  also  in 
the  room,  spoke  to  her,  but  D.  F.  gave  no  response, 
and  said,  in  answer  to  my  questions,  that  she  did  not 
hear  her.  When  awakened  she  could  remember  every- 
thing I  said,  but  did  not  remember  anything  that  Mrs. 
S.  had  said  until  I  insisted  that  she  should,  whereupon 
recollection  was  complete. 

1  September  24th.     This  chart  showed  a  fully  normal  field  of  vision. 


> 


d 


X 

u 


> 


ft 
6 


102  Psychopathological  Researches 

"Experiment  3. —  Hypnosis;  eyes  open.  Asked 
whom  she  saw  in  the  room,  replied,  '  Dr.  W.  and  Mrs. 
S.'  Eyes  shut,  I  make  several  remarks  to  her;  Mrs. 
S.  also  speaks  to  her,  but  she  does  not  reply,  and  says, 
in  answer  to  my  questions,  that  she  heard  nothing. 
During  the  hypnosis,  a  third  person  comes  to  the  door 
of  the  room  and  speaks  to  me.  Awakened,  memory 
of  all  that  I  said  was  complete  ;  she  was  also  able  to 
recollect  everything  that  Mrs.  S.  and  the  third  person 
who  came  to  the  door  said,  but  said  that  she  had  not 
heard  them  speak  during  hypnosis,  and  at  present, 
although  she  detailed  to  me  every  portion  of  the  con- 
versation which  occurred,  she  had  no  means  of  know- 
ing whether  such  conversation  was  the  correct  one  or 
not." 

Dr.  S's  advice  was  not  to  continue  any  hypnotic  ex- 
periments with  the  patient,  so  as  not  to  disturb  the 
equilibrium  of  the  synthetized  systems  and  thus  run 
the  risk  of  new  dissociations. 

The  patient  is  now  in  good  health.  Organic  func- 
tions work  regularly  and  normally,  and  there  are  no 
disturbances  either  in  the  waking  state  or  during  sleep. 
The  patient  has  been  working  during  the  summer  of 
1898  and  is  now  attending  school.  Since  her  discharge 
from  the  hospital  she  has  had  no  return  of  any  of  the 
symptoms  which  led  to  her  committal.  The  patient's 
mental  condition  remains  normal  and  there  has  been 
no  recurrence  for  the  period  of  five  years  of  the  con- 
traction of  the  field  of  vision. 


Mental  Dissociation  in  Alcoholic  Amnesia- 

By 

William  A.  White 


CHAPTER  I 

AMNESIA    AND    HYPNOIDAL    STATES 

The  whole  subject  of  amnesia,  whether  of  alcoholic 
or  other  origin,  is  so  little  understood  and  of  so  much 
importance  that  I  believe  any  contribution  to  its  psy- 
chopathology,  however  slight,  will  be  welcomed.  I 
have,  therefore,  decided  to  present  the  following  case, 
though  fully  realizing  that  it  can  only  be  considered 
as  suggestive  in  its  implications. 

Mr.  X.,  a  middle-aged  gentleman,  not  addicted  to 
the  use  of  alcoholics,  but  only  occasionally  indulging 
in  a  social  glass,  inadvertently  drank  too  much,  and 
as  a  consequence  suffered  from  amnesia  for  a  period 
of  three  hours,  during  which  he  was  intoxicated.  The 
following  is  his  account  of  all  he  could  remember  of 
the  events  leading  up  to  and  including  the  period  of 
intoxication,  upon  the  occasion  of  his  relating  them 

to  me. 

103 


104  Psychopathological  Researches 

In  September,  1898,  at  about  11  a.m.,  he  met  a 
gentleman  in  the  City  ;  he  was  introduced,  talked,  and 
began  drinking  Manhattan  cocktails.  About  noon 
he  suggested  having  lunch  and  they  went  together  to 
a  dining-room,  but  before  eating  drank  another  cock- 
tail. Mr.  X.  by  this  time  was  feeling  rather  "  shaky." 
After  lunch,  which  consisted  of  corned  beef,  cabbage, 
and  apple-pie,  they  had  cigars,  and  the  gentleman 
proposed  they  go  to  his  office,  where  they  had  more 
cigars,  and  then  started  for  a  drive.  Mr.  X.  tele- 
phoned for  a  team  to  meet  them  at  the  Hotel  B. 
They  went  there  and  found  the  team,  got  in,  returned 
to  the  restaurant,  and  had  another  cocktail.  From 
there  they  drove  over  a  bridge — not  sure  of  the  name 
of  the  street  they  drove  on,  it  was  the  other  side  of 
the  railroad  tracks, —  made  two  or  three  stops  for 
drinks  and  came  to  a  place  where  there  were  a  num- 
ber of  cars — he  thinks  it  must  have  been  the  town  of 
U.  As  it  was  getting  late  by  this  time  they  turned 
about  and  drove  back  towards  home  on  R.  street 
very  fast,  and  reached  F.  street  about  6.30  p.m.  Here 
Mr.  X's  friend  got  out  and  Mr.  X.  drove  down  F. 
street  to  C.  street,  and  turned  in  the  direction  of  the 
bridge,  after  which  he  recalls  no  more  until  he  heard 
a  pounding  like  some  one  pounding  on  a  door  and 
some  one  said  :  "  Are  you  sick  ?  It  is  time  to  close 
up."  He  awoke  in  one  of  the  closets  of  the  A.  hotel. 
He  adjusted  his  clothing  and  got  out.  He  thought 
it  must  be  about    closing   time,  viz.,  midnight ;  but 


Amnesia  and  Hypnoidal  States         105 

when  he  reached  the  street  it  was  only  9.30  p.m. 
He  hurriedly  went  home,  took  a  dose  of  compound 
licorice  powder,  and  went  to  bed.  When  he  awoke, 
his  first  thought  was :  "  Where  are  the  horses  ? " 
He  could  recall  nothing  about  them  and  was  ap- 
prehensive that  an  accident  had  occurred,  although 
he  felt  all  right.  He  examined  his  clothing  and 
found  no  evidences  of  an  accident  in  their  appear- 
ance. He  went  to  S's  livery-stable  and  asked  how 
the  team  got  home,  and  they  told  him  that  he  (Mr. 
X.)  drove  it  home.  The  man  smiled  and  said  he 
seemed  to  be  asleep  when  he  returned ;  that  he 
jumped  from  the  box  when  he  arrived,  said  nothing 
to  any  one,  and  walked  off.  His  idea  is  that  when  he 
got  off  the  box  at  the  stable  he  must  have  gone  to 
the  hotel  to  the  closet,  but  the  A.  hotel  was  not  on  his 
way  home  from  the  stable,  and  the  C.  hotel  was  right 
next  to  the  stable. 

The  entire  period  from  6.30  p.m.  to  about  9.30  p.m., 
or  the  time  he  was  awakened  in  the  hotel,  about  three 
hours,  is  effaced  from  his  memory.  I  felt  convinced, 
however,  that  it  would  be  possible  to  obtain  a  com- 
plete recollection  for  this  period,  as  it  was  quite  im- 
possible for  him  to  have  been  unconscious  during  it. 
The  various  things  which  he  must  have  done — walking 
about  the  streets,  going  to  the  hotel — must  have 
been  intelligent  acts,  or  otherwise  they  would  have 
attracted  attention  and  excited  comment.  The  acts 
must  also  have  been  of  a  too  complicated  nature  to 


106  Psychopathological  Researches 

be  designated  as  automatic.  In  other  words,  instead 
of  being  in  a  condition  of  ^^consciousness  he  must 
have  been  in  a  condition  of  other  consciousness  for 
which  in  his  ordinary  waking  state  he  was  amnesic. 

With  reference  to  this  matter  of  confusing  amnesia 
with  unconsciousness,  let  me  quote  from  Van  Gieson 
and  Sidis,  who  say  very  justly  : 

"  From  the  fact  of  amnesia,  unconsciousness  is 
inferred,  because  the  two  are  thought  to  be  identical. 

"  Now  we  must  strongly  emphasize  the  fact,  how- 
ever elementary  and  trite  it  may  appear  to  the  scien- 
tist, that  amnesia  in  no  wise  implies  unconsciousness. 
The  two  are  not  the  same.  While  unconsciousness, 
being  a  cessation  of  all  psychic  activity,  includes  ipso 
facto  a  lack  of  memory,  or  amnesia, — for  there  can  be 
no  recollection  of  what  did  not  exist  as  a  psychic 
state, — amnesia,  on  the  other  hand  (even  if  it  be  real), 
does  not  necessarily  include  unconsciousness.  The 
fact  that  one  can  not  remember  what  has  happened 
to  him  does  not  in  the  least  imply  that  the  past  state 
was  an  unconscious  one.  A  fall,  a  blow  on  the  head, 
may  obliterate  from  memory  whole  periods  of  high 
intellectual  activity,  but  it  would  certainly  be  wrong 
to  conclude  from  the  state  of  amnesia  now  present 
that  the  patient  for  all  that  period  that  had  lapsed 
from  his  memory  was  an  unconscious  automaton. 

"  From  the  mere  fact  of  amnesia  or  of  total 
'  oblivion,'  we  have  no  right  to  infer  even  a  dimin- 
ished or  semi-conscious  state.     A  very  high  and  in- 


Amnesia  and  Hypnoidal  States         107 

tense  state  of  consciousness  may  become  dissociated 
from  the  rest  of  conscious  life,  and  be  incapable  of 
reproduction  in  the  synthesis  of  memory.  The  phe- 
nomena of  double  or  multiple  personality  and  of  post- 
hypnotic states  may  serve  as  good  examples.  From 
a  psychological  standpoint,  memory,  objectively  con- 
sidered, is  a  present  mental  reproduction  and  recog- 
nition of  one's  past  conscious  experience,  and  the  loss 
of  the  first  two  conditions,  of  reproduction  and  recog- 
nition, does  not  in  the  least  imply  the  non-existence 
of  that  conscious  experience.  In  short,  amnesia  is 
not  identical  with  unconsciousness."  1 

If  Mr.  X.  was  not  unconscious  during  this  period 
of  three  hours,  he  must  then  retain  the  memories  of 
what  he  did  in  his  subconsciousness,  and  I  decided  to 
employ  a  modification  of  the  method  of  hypnoidiza- 
tion  for  determining  this. 

This  method,  as  described  by  Dr.  Sidis,2  to  whom 
we  are  indebted  for  it,  is  as  follows  : 

"  The  patient  is  asked  to  close  his  eyes  and  keep  as 
quiet  as  possible,  without,  however,  making  any  spe- 
cial effort  to  put  himself  in  such  a  state.  He  is  then 
asked  to  attend  to  some  stimulus;  such  as  reading  or 
singing.  When  the  reading  is  over,  the  patient,  with 
his  eyes  still  shut,  is  asked  to  repeat  it,  and  tell  what 
came  into  his  mind  during  the  reading,  during  the 
repetition,  or  after  it.     Sometimes,  as  when  the  song 

1  "  Epilepsy  and  Expert  Testimony,"  State  Hospital  Bulletin,  April,  1897. 

2  The  Psychology  of  Suggestion,  p.  224. 


108  Psychopathological  Researches 

stimulus  is  used,  the  patient  is  simply  asked  to  tell  the 
nature  of  ideas  and  images  that  entered  into  his  mind 
at  that  time  or  soon  after."  By  this  method  we  are 
enabled  to  distract,  draw  off,  completely  occupy,  in 
fact  remove,  as  it  were,  the  personal  consciousness  of 
the  patient,  and  thus  allow  the  subconsciousness  to 
act  unhampered  by  the  inhibitions  of  the  upper  self. 
The  personal  or  upper  consciousness  of  the  patient 
being  fully  occupied,  by  close  attention  to  the  stimuli 
used,  fails  for  the  nonce  to  exercise  its  inhibitory  con- 
trol over  the  subconsciousness,  which  in  its  turn, 
finding  itself  thus  relieved  from  censorship,  acts 
spontaneously.1 

I  had  Mr.  X.  sit  in  a  room  only  dimly  lighted  and 
very  quiet,  in  a  semi-reclining  position,  and  then, 
assuring  him  that  the  memories  would  return  (influ- 
ence of  suggestion),  asked  him  to  fix  his  attention  on 
the  events  just  related,  more  particularly  at  that  point 
where  memory  ceased,  and  see  if  he  could  not  recall 
additional  facts.  This  modification  of  the  method  of 
hypnoidization  was  first  used  by  Dr.  Sidis  and  myself 
in  the  M.  case.  I  asked  him  to  think  of  the  events 
related,  so  as  to  exclude  extraneous  thoughts  as  far 
as  possible  and  to  assist  any  latent  tendency  that 
might  be  present  to  recall  events  associated  with 
the  forgotten  occurrences.  I  obtained  the  following 
results  : 

1  Wm.  A.  White,  M.D.,  "Preliminary  Experimental  Studies  in  a  Case  of 
Amnesia  with  a  Discussion  of  their  Psychopathological  Significance,"  Archives 
of  Neurology  and  Psychopathology,  vol.  i.,  No.  4,  1898. 


Amnesia  and  Hypnoidal  States         109 

He  sees  the  stable  more  plainly  than  before  and 
imagines  going  in  and  throwing  the  lines  aside  and 
jumping  off  the  box ;  he  then  comes  out  and  walks 
along  to  C.  street,  and  then  to  the  A.  hotel  and  goes 
to  the  closet. 

Effort  continued  :  Laughs  because  he  sees  himself 
catch  a  tree  for  support ;  runs  for  the  tree,  for  he  felt 
as  if  he  was  going  to  fall ;  the  tree  was  in  front  of 
Mr.  M's ;  from  the  tree  he  ran  to  the  hotel. 

Effort  continued  :  Smiling  ;  does  not  recall  going 
from  the  hotel  to  the  closet,  but  recalls  being  very 
anxious  to  go  there  ;  after  there,  he  was  very  sick  and 
vomited,  and  went  to  sleep  sitting  there  and  did  not 
awake  until  some  one  knocked  on  the  partition  be- 
tween the  closets,  because  he  had  locked  the  door  to 
the  closet  and  it  could  not  be  opened. 

At  this  point  he  told  me  what  he  had  previously 
forgotten,  viz.,  that  S.  (the  liveryman)  told  him  that 
some  one  telephoned  him  that  the  man  who  had  his 
cobs  out  was  driving  down  C.  street  asleep  on  the  box. 

Effort  continued  and  directed  by  me  :  I  tried  to 
get  him  to  recall  the  events  immediately  after  his 
friend  got  out  of  the  carriage  and  he  turned  down  C. 
street,  but  he  failed.  I  now  tried  to  get  him  to  recall 
the  events  when  he  arrived  at  the  stable.  He  seems 
to  be  asleep  on  the  box  ;  while  going  along  he  pulls  the 
horses  up  suddenly  to  let  a  wagon  from  a  side  street 
go  by,  and  then  goes  on  along  a  street  that  is  all  torn 
up  and  goes  to  the  stable  and  jumps  off  the  box. 


no         Psychopathological  Researches 

This  experience  was  not  as  well  recognized  as  the 
former  ones  recalled,  but  when  questioned  about  the 
recognition  element  felt  sure  that  it  was  himself,  but 
his  answers  evidenced  some  hesitancy.  However,  as 
we  conversed  about  it  he  said  it  was  all  plain  to  him 
now  as  he  could  see  himself  in  blue  clothes,  with  his 
hat  pulled  over  his  eyes,  driving  along  holding  the 
reins  carelessly. 

Effort  continued  :  Does  not  recall  any  of  the  per- 
sons or  faces  he  came  in  contact  with  during  this 
period  ;  he  now  tries  to. 

Some  orie  was  in  the  stable  when  he  arrived,  but  he 
did  not  notice  who  it  was.  He  knows  that  when  he 
left  the  stable  he  felt  glad  that  it  was  dusk  ;  the  lights 
were  being  lit  and  the  streets  were  pretty  well  de- 
serted—  probably  between  6:30  and  7  p.m.  He  says 
he  went  right  along  without  looking  to  the  right  or 
left,  and  therefore  can  recall  no  faces,  as  he  was  in  a 
hurry  to  get  to  the  hotel. 

Sees  stable  of  S.  lighted  up  ;  never  in  there  before 
when  it  was  illuminated  ;  some  one  came  to  take  his 
horses,  but  he  does  not  know  who  ;  no  one  spoke  to 
him. 

I  asked  him  to  try  and  recall  why,  when  he  left  S's, 
he  went  to  the  A.  hotel  rather  than  the  C.  hotel 
which  was  much  nearer.  He  says  because  when  he 
left  the  stable  he  wanted  to  defecate,  and  chose  the 
A.  hotel  because  he  was  more  familiar  with  the  toilet 
there  than  at  the  C.  house. 


Amnesia  and  Hypnoidal  States         in 

When  he  staggered  about  the  tree,  he  was  seized 
with  the  first  inclination  to  vomit,  and  then  was 
anxious  to  get  to  the  hotel  for  a  double  reason. 
He  vomited  in  the  cuspidor  while  sitting  in  the 
toilet. 

My  associate,  Dr.  Gillespie,  who  was  present  during 
my  examination,  says  that  he  told  him  about  having 
vomited  before  when  relating  the  circumstances  con- 
nected with  his  intoxication  to  him. 

Says  as  he  sat  in  the  toilet  he  moaned  constantly, 
and  that  is  probably  what  led  the  man  to  knock  on 
the  partition. 

He  remembers  distinctly  that  he  was  much  cha- 
grined, and  wished  he  had  eaten  more,  and  wondered 
why  he  had  ever  gotten  into  such  shape. 

Told  me  he  stopped  at  F's  cafe  after  he  got  in  the 
carriage,  but  Dr.  Gillespie  said  Mr.  X.  told  him  once 
before  he  had  F.  bring  out  two  cocktails.  This  he 
now  recalls,  but  did  not  when  he  first  recounted  it  to 
me. 

Again  very  undecided  whether  his  recollection  of 
driving  through  C.  street  asleep  on  the  box  is  a  true 
memory  of  what  he  himself  passed  through  or  not. 
Recognition  element  somewhat  in  abeyance  —  much 
confused.  After  his  friend  left  the  carriage  he  turned 
into  C.  street,  and  then  a  blank  (asleep  ?)  ;  when  the 
team  interrupted  him  he  awoke,  then  a  blank  (asleep  ?) 
until  he  entered  the  stable. 

I  told  him  that  if  he  had  been  asleep  on  these  two 


ii2         Psychopathological  Researches 

occasions  he  would  recall  the  sensation  of  being 
awakened  ;  this  he  did  for  the  first  blank.  The  team 
that  drove  in  front  of  him  caused  his  horses  to  stop  ; 
he  did  not  stop  them,  but  opened  his  eyes  and  looked 
around.  He  cannot,  however,  recall  the  sensation  of 
awakening  from  the  second  blank. 


CHAPTER    II 


THE    LAPSED    PERIODS 


Here,  then,  we  have  a  case  of  amnesia  for  a  period 
of  three  hours,  due  to  alcohol.  The  great  importance 
of  a  careful  experimental  study  of  such  a  state  is  evi- 
dent, especially  if  we  take  into  consideration  the  large 
number  of  crimes  committed  for  which  amnesia  is 
subsequently  claimed  by  the  criminal. 

It  is  noteworthy  in  reviewing  this  case  that  Mr.  X. 
told  me  about  having  vomited  as  an  entirely  new  rec- 
ollection, whereas  he  had  told  Dr.  Gillespie  this  be- 
fore. This  tendency  of  subconscious  memories  to 
crop  out  in  the  upper  consciousness  momentarily  and 
then  to  sink  back  again  into  oblivion  is  quite  charac- 
teristic of  functional  amnesias.  I  have  often  observed 
it.  It  is  important,  too,  because  in  the  absence  of  a 
knowledge  of  this  fact  such  a  phenomenon  might  lead 
to  a  suspicion  of  malingering. 

Especially  hard  is  it  to  get  at  the  truth  in  cases 
where  a  crime  has  been  committed,  as  often  there  is 
little  else  than  the  subjective  statement  of  the  crimi- 
nal to  the  effect  that  he  has  no  recollection  of  what 
occurred. 

In  this  case  there  were  unfortunately,  or  fortunately, 

113 


ii4         Psychopathological  Researches 

as  the  case  may  be,  no  unusual  occurrences  by  which 
the  mental  condition  of  Mr.  X.  during  the  period  for 
which  he  was  afterwards  amnesic  could  be  gauged. 
I  think,  however,  that  we  may  posit  what  that  condi- 
tion was  in  other  cases  where  we  have  a  complete 
record  of  what  occurred,  when  we  take  into  considera- 
tion that  the  patients  must  have  been  conscious  of 
what  they  were  doing,  provided  their  acts  were  at  all 
complicated,  a  thesis  I  think  we  are  fully  justified  in 
adopting,  especially  after  having  been  able  to  prove 
that  consciousness  actually  did  exist  in  a  single  case — 
that  of  Mr.  X. 

The  following  case,  for  example,  is  given  by  Sulli- 
van,1 and  cited  as  a  good  example  of  the  automatic 
type  of  alcoholic  homicide  : 

"  K ,  aet.  28,  a  sailor.  Father  mentally  un- 
stable, suffered  from  fits  (of  uncertain  nature)  ;  pa- 
ternal uncle  died  insane.  Patient  himself  said  to 
have  had  sunstroke.  When  sober  appeared  of  nor- 
mal feeling  and  intelligence  ;  when  intoxicated  was 
violent.  Drinking  for  about  ten  years  at  intervals 
determined  by  his  occupation  ;  convicted  three  times 
as  drunk  and  disorderly,  the  first  occasion  six  years 
before  his  crime. 

"  On  the  evening  of  the  eleventh  day  of  a  severe 
drinking  bout  |was  seen  to  go  home  with  his  wife, 
being  apparently  on   boisterously  affectionate  terms 

1 W.   C.    Sullivan,    "  Alcoholic    Homicide,"    Journal  of    Mental   Science, 
October,  1900. 


The  Lapsed  Periods  115 

with  her.  During  the  night  he  killed  her  by  cutting 
her  throat  with  a  razor  as  she  lay  in  bed,  and  made  an 
almost  successful  attempt  to  commit  suicide  with  the 
same  weapon.  Professed  to  have  no  memory  of  the 
act,  and  could  not  at  any  subsequent  time  suggest  a 
motive  for  it.  While  under  treatment  for  his  self- 
inflicted  wound  suffered  from  severe  alcoholic  symp- 
toms, nervous  and  digestive." 

Foster's1  definition* of  automatic,  which  seems  to 
me  to  be  quite  in  accord  with  the  facts,  is  as  follows : 
11  Self-acting,  i.  e.,  without  the  intervention  of  the 
will  (said  of  physiological  acts  and  of  the  mechanisms 
by  which  they  are  performed).  The  term  is  applied 
to  acts  which,  although  voluntary  at  first,  become 
habitual  and  continue  to  be  performed  without  any 
further  attention  being  bestowed  on  them."  A  classi- 
cal example  is  that  of  the  pianist,  who,  having  learned 
a  piece,  continues  to  play  it  while  holding  an  animated 
conversation  with  a  bystander.  Surely  there  is  nothing 
in  this  case  described  by  Sullivan  that  would  bring  it 

within  this  conception  of  automatic.       K could 

hardly  be  accused  of  having  performed  such  an  act  as 
cutting  his  wife's  throat  with  such  frequency  that  it 
had  become  habitual,  self-acting,  automatic. 

A  state  of  mind  which  can  conceive  of  two  separate 
crimes,  seek  out  the  appropriate  instrument  for  their 
execution,  succeed  in  consummating  one  and  in  nearly 
completing  the  second,  is  certainly  of  a  sufficiently 

1  Foster's  Encyclopaedic  Medical  Dictionary. 


n6         Psychopathological  Researches 

complex  nature  to  warrant  the  assumption  that  con- 
sciousness was  present  and  directed  the  several  acts* 
The  amnesia  which  followed  may  have  been  functional 
or  organic ;  experimental  research  alone  could  deter- 
mine this.  It  is  quite  conceivable,  however,  that  the 
violence  of  the  process  which  brought  about  the  acts 
may  have  been  sufficient  to  destroy  the  physical  sub- 
stratum of  the  consciousness  which  accompanied 
them,  a  state  of  affairs  possibly  present  at  times  in 
epilepsy. 

Such  a  case  as  the  following,  however,  is  quite  pos- 
sibly altogether  automatic  in  character1  : 

"  Take   the  case  of    the  woman   E.    C ,   first 

quoted  by  Dr.  Orange. 

"  One  day,  whilst  dressing  her  infant,  she  rose  with 
the  view  of  procuring  some  bread  and  butter  for  an- 
other child.  She  had  a  slight  seizure,  and  instead  of 
cutting  the  bread,  severed  her  infant's  arm  at  the 
wrist.  When  she  recovered  consciousness  she  found 
several  neighbors  and  a  policeman  in  the  room,  the 
latter  taking  from  her  the  severed  hand,  which  she 
was  fondling.  Once  before,  in  cutting  bread,  she  un- 
consciously injured  her  thumb.  She  had  no  recollec- 
tion of  either  act.  During  her  asylum  life  she  suffered 
from  both  grand  mal  and  petit  mal.  The  attacks 
usually  came  on  about  the  third  day  after  the  catame- 
nial  period.    She  was  occasionally  maniacal,  gradually 

'John  Baker,  "Epilepsy  and  Crime,"  Journal  of  Mental  Science,  April,. 
1 901. 


The  Lapsed  Periods  117 

drifted  towards  dementia,  and  finally  died  of  cancer 
of  the  vagina." 

In  this  case  the  woman  started  to  do  an  act  to 
which  she  was  fully  accustomed,  viz.,  cut  some  bread. 
On  starting  to  cut  the  bread  she  had  an  attack,  and 
the  act  begun  in  the  waking  state  was  continued  auto- 
matically in  the  epileptic  state,  the  baby's  hand  being 
cut  off  because  of  its  unfortunate  proximity,  being 
seized  instead  of  the  bread  and  the  difference  not 
appreciated. 

It  is  probable  that  acts  committed  in  a  condition  for 
which  there  is  subsequent  amnesia  are  the  results  of 
various  causes.  The  acts  of  blind  fury  during  which 
everything  within  reach  is  destroyed,  and  murderous 
assaults  made  upon  those  about,  are  probably  as  nearly 
automatic  as  any,  although  I  think  that  these  states 
are  often  accompanied  by  a  low  degree  of  conscious- 
ness, and  in  a  case  that  came  directly  under  my  obser- 
vation,1 in  which  the  condition  was  aggravated,  though 
not  caused  by  alcohol,  there  was  perfectly  clear  con- 
sciousness on  the  part  of  the  patient  of  what  he  was 
doing,  as  was  proved  by  subsequent  complete  recollec- 
tion. These  conditions  are  probably  often,  as  in  the 
case  referred  to,  the  result  of  angry  states  waxed  into 
violence  by  the  removal  of  the  ordinary  controls  of 
conduct  and  frequently  aggravated  by  hallucinations, 
delusions,  and  obsessions. 

1  Dr.  Wm.  A.  White,  "  The  Retraction  Theory  from  a  Psychical  Standpoint," 
Proceedings  American  Medico-Psychological  Association,  1899. 


n8  Psychopathological  Researches 

This  condition  is  well  illustrated  in  the  case  quoted 
by  Sullivan,1  although  in  this  case  amnesia  for  the 
acts  committed  did  not  occur. 

"  David  Baines,  set.  41,  fish-dealer.  No  definite 
evidence  of  hereditary  taint ;  his  long  resistance 
to  alcohol  suggests  a  normally  stable  brain.  His 
drinking  habits  dated  back  some  twenty  or  twenty- 
five  years,  and  within  two  or  three  years  of  his  crime 
he  had  several  attacks  of  delirium  tremens ;  also, 
without  actual  delirium,  he  often  suffered  from  hallu- 
cinations, tremors,  and  insomnia.  Under  the  influ- 
ence of  drink  he  was  wont  of  late  to  become  extremely 
violent,  and  would  manifest  suspicions  of  his  wife's 
fidelity ;  he  would  then  accuse  her,  watch  her  move- 
ments, threaten,  or  even  assault  her ;  on  two  occa- 
sions when  in  this  state  he  attempted  to  commit 
suicide.  When  sober  he  did  not  entertain,  or  at  least 
did  not  express,  these  ideas. 

"  From  June  to  Christmas  day,  the  date  of  the  mur- 
der, Baines  drank  very  heavily.  On  Christmas  eve  he 
had  a  violent  quarrel  with  his  wife ;  the  wrangling 
lasted  late  into  the  night ;  Baines  stayed  up,  walking 
about  the  house,  talking  to  himself,  and  occasionally 
beating  his  head  against  the  wall.  Early  on  Christ- 
mas morning-  the  woman  went  to  a  neighbor's  house 
to  ask  the  time.  Baines,  who  had  got  possession  of  a 
knife  and  had  sharpened  it,  followed  her  there  and 
stabbed  her  fatally.     Arrested  immediately  after,  he 

1  Loc.  cit. 


The  Lapsed  Periods  119 

said  :  '  It  is  all  over  last  night's  affair ;  I  saw  it  with 
my  own  eyes  ;  I  did  it  deliberately  over  that.'  Thirty 
hours  later  he  was  hallucinated  and  delirious,  his  ideas 
referring  to  the  murder  of  his  wife  and  to  his  own 
bodily  condition,  '  his  inside  was  taken  out,  half  of  his 
penis  was  cut  off.' 

"  Questioned  subsequently  regarding  his  crime,  he 
stated  that  his  wife,  who  constantly  deceived  him, 
brought  a  man  to  the  house  on  Christmas  eve  ;  he 
went  to  bed,  leaving  them  together,  and  soon  after, 
the  door  being  partly  open,  he  heard  filthy  conversa- 
tion between  them,  and  on  looking  out  saw  them 
having  connection  in  the  presence  of  the  children. 
After  this  the  woman  and  her  paramour  left  the  house 
separately.  Baines  slept  for  the  rest  of  the  night. 
Next  morning,  armed  with  a  knife,  he  followed  the 
woman  to  the  neighbor's  house  ;  his  intention  was 
merely  to  frighten  her,  but  at  the  last  moment  '  some- 
thing came  over  me,  and  I  could  not  help  doing  it  — 
I  don't  rightly  know  how  it  happened  —  I  was  not 
master  of  myself.' " 

In  other  cases  there  appears  strong  evidence  that 
the  mental  condition  under  alcohol  is  one  which  lends 
itself  easily  to  suggestion,  reminding  one  strongly  of 
the  hypnotic  state.  "  The  following  observation  !  may 
perhaps  be  regarded  as  an  instance  of  this  influence 
(external  suggestion),  though  the  absence  of  corrobo- 
rative evidence,  and,  assuming  his  veracity,  the  blurred 

1  Sullivan,  loc.  cit. 


120         Psychopathological  Researches 

condition  of  the  culprit's  memory,  leave  the  point  in 
doubt." 

"  P ,  set.  31.       No  fixed  occupation.     Mother 

died  of  a  '  fit ' ;  said  to  have  been  demented  for  some 
time  before  her  death.  A  cousin  on  the  maternal 
side  idiotic  ;  another  committed  suicide.  A  brother 
suffered  from  convulsions  in  childhood. 

"  Prisoner  was  always  idle  and  unstable  ;  lost  sev- 
eral engagements  through  drunkenness  ;  drinking  for 
over  ten  years  before  crime  ;  was  once  convicted  sum- 
marily for  drunkenness.  Had  had  rheumatic  fever 
and  syphilis,  and  suffered  from  mitral  disease. 

"  Three  days  before  the  crime,  prisoner  took  a 
room  in  a  brothel,  and  went  on  a  steady  drinking 
bout  with  one  of  the  girls  of  the  house.  On  the  day 
of  the  crime,  in  the  afternoon,  he  went  out  with  this 
girl  ;  having  had  some  drink  in  a  tavern  they  entered 
a  cab,  directing  the  driver  to  take  them  back  to  the 

brothel.     On  arriving  there,   P got  out   of  the 

cab,  and  told  the  driver  that  he  had  killed  the  girl, 
that  she  had  asked  him  to  do  so.     She  was  stabbed 

to  the  heart  with  a  penknife.     P could  give  no 

further  account  of  the  affair  :  the  woman  told  him  to 
stab  her,  and  he  obeyed,  as  one  might  in  a  dream." 

"  A  clearer  instance  of  the  same  agency  is  given  in 
a  case  recorded  by  Prosper  Despine,  where  one  of 
four  drunkards,  who  were  carousing  together,  sug- 
gested the  hanging  of  the  most  intoxicated  of  the 
party — a  suggestion  promptly  carried  out,  with  results 


The  Lapsed  Periods  121 

which  only  failed  of  being  fatal  through  the  accident 
of  outside  intervention." 

Thus  we  see  that  the  mental  state  during  the  alco- 
holic condition  may  be  variously  dominated.  The 
presence  or  absence  of  amnesia  appears  to  follow  no 
rule,  and  when  present  it  is  probable  that  the  mental 
condition  for  the  forgotten  period  was  dominated  in 
much  the  same  way  as  it  would  have  been  if  amnesia 
had  not  followed.  Sullivan a  records  two  instances 
of  alcoholics  who  committed  crimes  in  a  "  state  of 
obscured  consciousness  "  and  subsequently  developed 
delusions  which,  if  held  at  the  time,  would  have  been 
ample  to  have  constituted  a  motive.  It  appears  highly 
probable  to  me  that  such  a  crime  was  the  result  of 
delusions  which  in  the  following  period  of  amnesia 
were  forgotten,  only,  however,  to  crop  up  from  the 
regions  of  the  subconscious  at  a  subsequent  time  to 
dominate  the  upper  consciousness  as  delusions.  Ex- 
perimental research  alone  can  determine  whether  this 
is  so  or  not. 

I  have  cited  these  cases  only  for  the  purpose  of 
indicating  in  a  general  way  the  many  different  states 
of  mind  that  may  prevail  during  alcoholic  intoxica- 
tion, and  to  show  further,  that  it  is  not  sufficient  to 
dispose  of  a  case  by  simply  designating  it  as  amnesic. 
The  confounding  of  amnesia  with  unconsciousness 
has  been  largely  responsible  for  this,  but  now  that  we 
appreciate  the  distinction  an  effort  should  be  made  to 

1  Loc,  cit. 


122  Psychopathological  Researches 

study  fully  the  forgotten  period,  with  a  view  to  deter- 
mining the  character  of  the  dissociated  and  lapsed 
mental  states. 

This  plea  needs  no  justification  from  a  psycho- 
pathological  standpoint.  From  a  medico-legal  stand- 
point, however,  while  such  methods  may  be  of  no 
value  in  dealing  with  the  criminal  whose  principal 
safety  from  the  consequences  of  his  acts  lies  in  the 
acceptance  of  his  plea  of  forgetfulness,  still  there  are 
many  cases  of  "  psychical  automatism,"  so-called,  dur- 
ing which  important  business  transactions  are  entered 
into  or  consummated,  long  journeys  taken,  or  various 
other  acts  done,  for  which  there  is  subsequently  no 
memory,  where  it  might  be  a  matter  of  great  import- 
ance to  recall  what  has  been  forgotten. 


Mental  Dissociation  in  Psychic  Epilepsy 

By 

William  A.  White 


INTRODUCTION 

It  occasionally  happens  in  the  course  of  an  active 
medical  practice  that  the  physician  meets  with  a  case 
of  great  interest.  When  this  occurs  it  becomes  his 
duty  to  study  such  a  case  so  far  as  his  abilities  enable 
him  to,  and  present  the  results  thus  attained  to  the 
scientific  world  in  the  hope  that  he  may  have  added 
some  few  facts  to  the  mass  of  knowledge,  or  that  his 
studies  may  result  in  the  better  understanding  of  the 
class  of  cases  to  which  his  case  belongs. 

When,  however,  such  a  case  belongs  to  a  type 
little  studied,  about  which  hardly  anything  definite 
is  known,  and  when,  further,  it  presents  a  wealth 
of  symptoms  which  in  their  ensemble  are  closely  allied 
to  that  most  unfortunate  of  human  afflictions  —  in- 
sanity,—  it  becomes  doubly  the  duty  of  the  man 
under  whose  observation  such  a  case  falls  to  publish 
it  in  all  its  details. 

The  case  which  follows  is  such  an  one.     No  apology 

123 


124         Psychopathological  Researches 

is  required  for  offering  it  in  this  form.  It  presents  a 
wealth  of  manifestations  which  entitle  it  to  a  place  in 
the  annals  of  psychopathology. 

The  amount  of  experimental  work  done  was  so 
great  that  it  will  necessitate  months  of  patient  labor 
to  formulate  it  all  into  a  coherent  and  connected 
whole.  I  have,  therefore,  decided  to  present  a  re- 
view of  the  case  embodying  its  main  features,  trust- 
ing that  I  will  be  able  to  offer  the  details  at  no  very 
distant  future. 


CHAPTER  I 

ANAMNESIS    AND    PSYCHOPHYSICAL    EXAMINATION 

Anamnesis: — J.  A.  C,  female,  set.  fourteen,  na- 
tivity United  States,  was  admitted  to  the  Binghamton 
State  Hospital  at  Binghamton,  N.  Y.,  March  9,  1901. 
The  commitment  was  made  by  a  judge  on  the  facts 
contained  in  a  certificate  of  lunacy  made  by  two  duly 
qualified  examiners  in  lunacy  who,  after  having  ex- 
amined the  patient,  gave  it  as  their  opinion  that  she 
was  insane. 

The  petitioner  gives  as  his  reasons  for  desiring  his 
niece  committed  as  insane  that  she  "  does  not  recog- 
nize members  of  her  own  family,  refuses  to  take 
medicine,  has  purchased  poison,  and  attempts  to  com- 
mit suicide.  Has  to  be  watched  constantly."  The 
physicians  who  examined  her  made  the  following 
statements  on  which  their  diagnosis  of  insanity  was 
based  :  "  Said  did  not  care  where  she  was,  that  she 
would  sometime  kill  herself  and  had  things  to  do  it 
with.  Had  something  on  her  mind  that  worried  her 
all  the  time.  Found  fault  with  family  for  keeping 
her  locked  up  so  she  could  not  get  out.  Friends 
all  against  her,  trying  to  get  her  away  from  her 
home.     Crying,  violent  movements  and  acts  ;  at  times 

125 


126         Psychopathological  Researches 

appearing  quite  rational,  then  suddenly  becoming 
wild  so  that  she  has  to  be  held.  Refuses  to  take 
medicine  ;  during  attacks  urinates  in  bed  or  upon 
floor ;  also  bowels  move  in  same  manner.  Tries 
to  elude  family  in  every  way  with  suicidal  inten- 
tions. Did  succeed  in  taking  something  she  supposed 
to  be  poison." 

At  the  time  of  her  admission  to  the  hospital  the 
physician  who  was  in  the  office  made  the  following 
note  in  her  case  :  "  Patient  arrived  at  hospital  accom- 
panied by  attendant  and  Mrs.  W.  Petition  states 
that  patient  at  times  does  not  recognize  members  of 
her  family,  refuses  to  take  medicine,  has  purchased 
poison,  and  has  attempted  to  commit  suicide.  Medical 
certificate  states  that  patient  has  been  insane  since 
February  12,  1901,  that  at  times  patient  is  uncleanly, 
that  she  has  suicidal  tendencies,  and  that  this  attack  of 
mania  seems  to  have  been  caused  by  la  grippe,  love 
affair,  and  hereditary  tendency.  Her  mother  died  in 
an  asylum.  Patient  said  she  did  not  care  where  she 
was,  that  she  would  at  some  time  kill  herself,  that  she 
had  things  to  do  it  with,  etc.  In  the  medical  office 
patient  explained  to  the  examining  physician  that  at 
times  she  went  into  a  condition  where  she  would  lose 
all  control  of  herself  and  act  and  talk  in  a  most  irra- 
tional manner.  During  these  periods  she  would  both 
wet  and  soil  her  bed,  and  afterward  would  remember 
little  or  nothing  of  what  had  happened.  She  seemed 
pleased    to    think    that    she    was   about    to    receive 


Anamnesis  and  Examination  127 

medical  treatment  for  her  alienation  and  talked  most 
intelligently  about  herself  and  her  sickness." 

The  next  morning  I  visited  the  patient  and  obtained 
from  her  the  following  history  : 

She  says  that  for  the  past  year  and  a  half  to  two 
years  her  relatives  have  commented  on  the  fact  that 
she  has  not  acted  right,  but  no  active  symptoms  ap- 
peared until  from  four  to  six  weeks  ago.  Some 
months  ago  she  spent  some  time  with  a  relative  at  G. 
While  there  suffered  from  intense  headaches  and 
consulted  a  physician  who  told  her,  as  near  as  she  can 
recollect,  that  she  had  astigmatism,  and  inflammation 
of  the  eye  muscles,  but  that  back  of  it  all  there  was 
some  brain  trouble.  After  this  visit  she  spent  some 
time  with  an  aunt  at  N.  This  aunt  told  her,  what  she 
had  never  known  before,  viz.,  that  her  mother  died  in 
an  insane  asylum.  After  her  father's  death  her 
mother  worried  a  great  deal,  and  finally  became 
insane,  dying  only  about  two  weeks  after  being  taken 
to  the  asylum.  While  at  N.  she  had  alternate  attacks 
of  depression  and  exaltation.  During  the  stage  of 
depression,  she  was  gloomy  and  refused  to  talk ; 
during  the  stage  of  exaltation,  she  talked  constantly 
to  every  one's  great  annoyance.  It  was  here,  at  N., 
that  the  first  active  symptoms  developed.  This  first 
attack  came  on  suddenly  and  she  has  no  recollection 
of  anything  that  occurred  during  it ;  the  first  thing 
she  recalled  was  awakening  at  her  home  at  R.  and 
being  surprised  that  she  was  there,  not  understanding 


128         Psychopathological  Researches 

how  she  had  come  from  N.  Since  this  attack 
she  has  had  numerous  others.  The  first  was  the 
longest,  lasting  about  three  days,  the  others  were 
never  over  a  few  hours  in  duration.  On  one  oc- 
casion during  an  attack  she  bought  some  things  in  a 
grocery,  and  came  to  only  to  wonder  where  they  came 
from  and  what  she  had  done  with  her  money.  She  is 
acquainted  with  many  of  the  details  of  these  attacks 
from  having  been  told  them  by  her  relatives.  The 
most  constant  feature  seems  to  be  the  mistaking  of 
persons ;  especially  is  she  prone  to  mistake  those  about 
her  for  her  brother,  even  though  they  be  women. 
During  the  attacks  she  often  soils  herself. 

This  constitutes  the  entire  history  of  the  case  so 
far  as  I  was  able  to  obtain  it  from  all  sources  at  my 
command. 

Psychophysical  examination :  —  A  psychophysical 
examination  conducted  during  the  first  few  days  of 
her  residence  in  the  hospital  gave  the  following  results  : 

The  cutaneous  surface  was  anaesthetic  in  areas  dis- 
tributed over  both  sides  of  the  body  and  involving 
the  trunk  and  limbs.  These  areas  were  characterized 
by  their  greater  size  the  farther  they  were  located 
from  the  nerve  centres  (neuron  energy),1  and  by  their 
rapid  variation  in  size  and  outline.  Their  increase 
and  decrease  in  area  was  so  rapid  that  I  have  called 
them    "pulsating  areas    of  anaesthesia."      Extensive 

1  "Neuron  Energy,"  by  Van  Gieson  and  Sidis,  Archives  of  Neurology  and 
Psychopathology,  vol.  i.,  No.  I,  1898. 


Anamnesis  and  Examination 


129 


changes  would  take  place  in  a  few  moments,  so  that 
a  particular  spot  that  was  anaesthetic  at  the  time 
tested  might  not  be  so  a  few  moments  later,  or  vice 
versa. 

A  greatly  contracted  field  of  vision  extending  in 
the  four  principal  meridians  (see  Figure  1  7). 


Z.JS. 


R.K 


270°  SKEtL'SSELFRECORDlNG  PtfllMETCft.  _?70" 

FIGURE  17. 

Visual  fields  taken  March  25,  1901. 


Visual  fields  were  not  taken  before  this  date  be- 
cause of  the  high  degree  of  asthenopia  present. 

In  taking  fields,  it  is  my  habit  to  make  a  pencil 
mark  on  each  meridian  as  the  limit  of  vision  on  that 
meridian  is  determined,  and  then  outline  the  whole 
field  when  I  have  finished.  In  this  instance  I  dis- 
covered, when  I  came  to  outline  the  fields,  that  at 
O.  S.  900  I   had  two  pencil  marks — one  at  450  and 

one  at  550.       This   field  had   evidently  been   taken 

9 


i3°  Psychopathological  Researches 

twice  in  this  direction  and  varied  io°  between  the 
first  and  second  determination,  illustrating  well  that 
the  retinal  anaesthesia  closely  resembled  the  cutaneous 
in  its  property  of  extreme  and  rapid  variability  and 
instability. 

The  skiometer  showed  an  error  of  refraction  for 
both  eyes  of   —.50  cyl.  ax.   1800   for  which  she  was 

wearing 

O.  D.  +  .125  sph.  C  —  .25  cyl.  ax.  135  °. 
O.    S.  +  .125  sph.  O  —  -25  cyl.  ax.    45  °. 

It  was  found  possible  to  tap  the  subconscious 
through  both  the  areas  of  retinal  and  of  cutaneous 
anaesthesia.  If,  for  example,  I  asked  J.  to  think  of  a 
number  and  then  pricked  an  anaesthetic  spot  a  certain 
number  of  times  the  number  thought  of  would  corre- 
spond  to  the  number  of  pricks.  Similarly,  if  an  object 
was  so  held  that  its  image  was  cast  upon  the  anaes- 
thetic area  of  her  retina,  i.  e.,  upon  the  area  lying  be- 
tween the  limits  of  her  field  of  vision  and  the  field 
which  is  normally  visually  active,  and  she  was  asked 
to  name  the  first  object  that  came  to  her  mind,  she 
would  name  the  object  held  before  her,  although 
throughout  the  experiment  she  had  been  unable  to 
see  it. 

During  the  first  two  days  of  J's  residence  in  the 
hospital  she  had  two  attacks  followed  by  complete 
amnesia.  During  the  greater  portion  of  the  first  of 
these  attacks  I  was  with  her  and  so  enabled  to  make 
a  number  of  important  and  interesting  observations. 


Anamnesis  and  Examination  13 1 

In  both  her  normal  condition  and  during  her  at- 
tacks she  suffered  from  a  well-developed  suicidal 
obsession,  and  from  erythrophobia  (spvdpoz,  red, 
cpofiog,  fear).  Her  attacks  are  ushered  in  by  a  distinct 
sensory  aura  :  pain  in  the  occiput.  During  the  attack 
in  which  I  saw  her  she  did  not  recognize  those  about 
her  but  mistook  them  for  friends  and  relatives  and 
did  not  realize  where  she  was,  evidently  thinking  she 
was  home.  She  also  said  and  did  things  for  which 
there  was  no  apparent  reason. 

J.  is  hypnotizable,  sinking  readily  into  deep  somnam- 
bulism, during  which  state  she  accepts  suggested  hal- 
lucinations both  positive  and  negative.  She  also 
accepts  post-hypnotic  suggestions. 

She  is  very  bright  and  was  a  good  student  at  school, 
and  is  very  much  alive  to  all  that  is  going  on  about 
her.  She  is,  however,  self-centred,  given  to  morbid 
introspection,  and  not  interested  in  things  which 
ordinarily  interest  girls  of  her  age. 

Emotionally  she  is  very  mercurial,  easily  pleased 
and  as  easily  hurt.  She  has  a  tendency  to  alternate 
between  conditions  of  comparative  exaltation  and  of 
comparative  depression.  During  the  former  she  is 
happy,  smiling,  and  very  active,  and  apt  to  overdo 
and  become  greatly  fatigued.  This  fatigue  assists  in 
producing  the  depressed  state,  during  which  she  is 
overwhelmed  by  depressing  thoughts,  quiet  and  in- 
active, her  mind  constantly  occupied  by  the  idea  of 
self-destruction. 


CHAPTER   II 

ORIGIN    AND    GROWTH    OF    DISSOCIATION  . 

I  propose  to  present  in  this  chapter,  arranged 
chronologically,  aconnected  story  of  the  origin  and  de- 
velopment of  the  many  phenomena  which  the  patient 
presented  ;  in  other  words  the  story  of  her  case  with- 
out reference  to  experimentation  and  with  only  a 
sufficient  amount  of  comment  to  make  it  a  clear 
connected  whole  and  to  show  the  relations  and 
dependencies  between  its  different  parts. 

At  the  tender  age  of  one  and  one  half  years  J.  lost 
her  father.  He  had  been  ailing  for  some  little  time 
and  died  finally  from  a  complication  of  diseases  in 
which  the  heart  and  kidneys  figured  prominently.  Her 
mother,  who  was  very  much  devoted  to  her  husband, 
never  fully  recovered  from  the  shock  of  his  death,  and 
one  year  afterward,  as  a  result  of  continual  grieving 
and  the  increased  work  made  necessary  by  added 
responsibilities,  she  became  insane.  She  was  taken 
to  a  State  Hospital  but  only  survived  for  two  weeks. 

J.  has  two  sisters,  J-n-y  and  M.,  and  one  brother, 
H.,  who  are  respectively  eleven,  sixteen,  and  nine- 
teen years  older  than  she. 

At  a  very  early  age  then  we  see  that  J.  was  de- 

132 


Origin  and  Growth  of  Dissociation       133 

prived  of  that  most  important  of  elements  in  the 
proper  development  of  the  child  mind  :  the  solicitous 
care  and  love  of  parents.  Her  sisters  and  brother 
were  too  old  to  sympathize  with  her  in  her  childish 
ideas  and  so  to  be  her  companions,  and  not  old  enough 
to  take  the  place  of  parents,  so  that  of  necessity  there 
was  much  lack  of  sympathy  between  her  and  them. 

Starting  in  life  with  a  probable  hereditary  taint, 
cared  for  by  a  brother  and  sisters  suffering  in  all  prob- 
ability from  the  same  taint  and  with  whom  she  had 
little  in  common,  she  was  certainly  seriously  handi- 
capped in  the  race  of  life.  Notwithstanding  all  this, 
however,  for  the  first  few  years  of  her  life  she  was  ap- 
parently a  normal  girl,  going  daily  to  school,  playing 
with  the  other  children,  interested  in  what  they  were 
interested  in,  happy,  jovial,  light-hearted,  and  withal 
much  like  other  children  of  her  age. 

At  the  age  of  ten  years  the  first  important  event  of 
her  life  occurred.  She  menstruated.  From  now  on 
her  character  underwent  a  radical  change.  From 
being  an  active,  happy-go-lucky  child  she  became  quiet 
and  sedate.  She  was  no  longer  interested  in  the  play 
of  other  children,  but  preferred  to  remain  at  home 
and  sew  or  read.  Her  manner  became  so  much 
changed  in  this  respect  that  it  was  a  matter  of  com- 
ment among  her  associates  and  they  often  remarked 
on  it.  Unfortunately,  too,  at  this  period  of  her  life 
phenomena  developed  which  tended  still  further  to 
give   a   morbid   character  to  her  acts  and  thoughts, 


i34  Psychopathological  Researches 

namely,  auto-erotism.1  During  this  period,  however, 
she  continued  in  school,  was  bright  and  got  on  well 
with  her  studies  and  was  comparatively  happy.  When 
she  was  eleven  and  one  half  years  old,  the  first  event 
occurred  to  which  definitely  can  be  traced  the  origin  of 
symptoms  which  ultimately  led  to  her  commitment  as 
insane.  It  was  three  and  a  half  years  ago,  on  New 
Year's  eve.  After  she  had  finished  her  evening  meal 
she  went,  as  often  she  had  done  before,  to  call  upon 
her  next-door  neighbor,  a  woman  with  whom  she  was 
quite  intimate.  While  sitting  chatting  in  the  darkness 
— the  lamps  had  not  yet  been  lighted  —  this  woman 
told  her  a  story  :  it  was  a  story  of  blood  and  death. 
She  told  her  of  a  young  man  who  became  discouraged 
with  life  and  resolved  to  commit  suicide  ;  of  how  he 
went  to  his  room  one  evening,  and,  after  writing  a  note 
telling  of  his  discouragement,  had  cut  his  throat. 
Death  not  coming  as  fast  as  he  had  wished,  he  jumped 
from  his  window  and  ran  toward  the  river,  into  which 
he  plunged  and  was  drowned.  She  told  her  all  this  and 
how  on  the  following  morning  he  was  traced  by  the 
splashes  of  blood  which  he  left  behind  in  his  path  as 
the  vital  fluid  trickled  from  the  wound  in  his  throat. 

Imagine  for  a  moment  the  effect  of  such  a  story 
upon  a  morbid,  emotional,  and  highly  sensitive  girl  of 
eleven  years  of  age,  told  in  the  darkness  of  the  night 

1  "  By  '  auto-erotism '  I  mean  the  phenomena  of  spontaneous  sexual  emotion 
generated  in  the  absence  of  an  external  stimulus  proceeding,  directly  or  in- 
directly, from  another  person." — Havelock  Ellis,  "Auto-Erotism,"  The  Psychol- 
ogy of  Sex,  vol.  II.,  1900. 


Origin  and  Growth  of  Dissociation       135 

in  all  its  horrible  details.  Is  it  strange  that  such  a 
gruesome  yarn  left  its  impression  so  deeply  seared 
into  her  brain  that  years  failed  to  eradicate  it  ?  Yet 
nature  is  so  careful  of  her  own  that  it  is  doubtful  if 
this  would  have  had  any  effect  whatever,  if  it  had  not 
been  for  the  events  which  immediately  followed.  That 
the  story  made  a  deep  and  morbid  impression  on  her 
is  shown,  however,  by  the  fact  that  during  its  relating 
she  thought  of  the  possible  effects  of  such  an  action 
on  her  part. 

After  finishing  her  visit  with  the  neighbor  she  went 
home.  It  was  now  about  nine  o'clock.  She  went  to 
the  sitting-room  and  began  playing  on  the  piano,  a 
favorite  pastime  of  hers.  While  she  was  playing, 
however,  the  same  idea  recurred, — what  would  her 
folk  think  if  she  killed  herself  ?  Would  her 
brother  care  if  she  did  ?  While  sitting  here  playing 
she  noticed  that  the  train  returned  to  the  station  after 
leaving  it  and  the  bell  kept  ringing.  (The  railroad 
station  was  only  a  short  distance  from  her  home  and 
the  sound  of  the  train  was  readily  discernible.)  She 
asked  her  brother  H.,  who  was  sitting  in  the  room 
reading,  the  reason  for  this.  He  was  deeply  en- 
grossed in  his  book  and  at  first  did  not  answer  her, 
but  to  her  repeated  questions  finally  answered  crossly 
and  told  her  to  stop  playing  the  piano.  He  had 
never  done  this  before  and  it  made  J.  feel  very  badly 
and  shortly  after  when  she  started  for  bed  neither  he 
nor  she  said  good-night. 


136  Psychopathological  Researches 

After  getting  into  bed  she  cried  about  her  brother's 
crossness  to  her  and  thought  still  of  what  effect  her 
suicide  would  have  on  her  folk.  She  finally  fell 
asleep  and  dreamt  of  the  suicide  and  also  that  if  she 
should  kill  herself  her  brother  would  not  care.  This 
made  her  feel  very  badly. 

She  was  dreaming  thus  when  she  was  suddenly 
awakened  by  the  front  door  slamming  and  the  sound 
of  her  brother's  footsteps.  The  first  idea  that  flashed 
to  her  mind  was  that  her  brother  did  not  like  her. 
She  then  heard  her  brother  say  to  a  man  who  kept 
his  horse  in  their  barn,  "Is  she  dead?"  and  then, 
"Which  way  did  Uncle  H's  folk  go?"  The  first 
question  immediately  brought  back  the  recollection 
of  the  suicide  and  the  second  the  thought  of  going  to 
the  river.  Then  her  brother  locked  the  door  and 
went  off  leaving  J.  in  the  house  alone.  She  was 
much  frightened,  and  in  her  agitation,  not  knowing 
what  had  happened,  she  walked  the  floor  crying. 
She  feared  that  her  sister  J.  had  been  killed.  In  this 
state  of  fear  and  apprehension  she  wished  she  was 
dead. 

It  was  in  this  state  of  mind,  while  walking  the  floor 
crying,  fearful  that  her  sister  had  been  killed  and 
with  the  remembrance  of  her  brother's  harshness  still 
fresh  in  her  mind,  that  the  desire  to  kill  herself  sug- 
gested by  the  story  of  the  boy's  suicide  came  first 
to  her  mind.  She  had  previously  only  thought  of 
suicide  in  a  general  way  and  of  the  effect  her  death 


Origin  and  Growth  of  Dissociation       137 

would  have  on  her  folk  :  she  now  for  the  first  time 
felt  an  actual  desire  to  end  her  life.  Feeling,  in  her 
childlike  way,  that  her  brother's  actions  could  only 
have  been  prompted  by  hate,  and  convinced  that  her 
sister  was  dead,  she  saw  nothing  to  look  forward  to  in 
life,  nothing  to  live  for. 

In  about  a  half-hour  her  brother  returned,  but  he 
did  not  as  yet  know  anything  definite  about  the  ac- 
cident and  went  out,  leaving  J.  alone  again  a  prey  to 
the  tyranny  of  her  own  thoughts. 

When  he  returned  the  second  time  he  had  learned 
that  while  J's  cousin  L.  had  been  out  driving  she 
had  been  struck  by  the  train  and  run  over.  He  made 
fun  of  J.  for  "  taking  on  "  so  and  told  her  that  her 
sister  J-n-y  was  at  Uncle  H's.  Her  sister  returned 
at  2.30  o'clock.  J.  was  much  worried,  however,  until 
she  returned,  despite  her  brother's  assurances. 

These  are  the  events  which  served  to  make  perma- 
nent the  damage  done  by  the  old  woman's  story  and 
the  effects  of  which  I  propose  to  trace  through  the 
following  three  and  one  half  years  of  J's  life. 

During  the  next  fourteen  months  nothing  of  con- 
sequence occurred.  The  events  just  recorded,  how- 
ever, had  done  their  work  well.  The  idea  of  suicide 
had  been  grafted  into  J's  mind,  there  to  grow,  to 
elaborate  itself,  and  to  wax  strong,  its  origin  lost  in  the 
depths  of  the  subconscious,  for  J.  no  longer  thought 
of  the  story  of  the  old  woman.  That  had  long  since 
passed  from  her  mind. 


i38  Psychopathological  Researches 

Here  is  the  first  definite  symptom  of  mental  dis- 
sociation in  the  case.  The  story  of  the  suicide  and 
the  events  that  followed  had  been  sufficient  to  pro- 
duce the  idea  of  suicide  in  J's  mind,  and  then  sinking 
from  view  into  the  depths  of  the  subconscious  they 
became  lost  as  dissociated  states.  Separated  from 
the  stream  of  the  upper  consciousness  they  are  lost 
to  view  by  the  patient,  and  their  causal  connection 
with  her  disturbed  mental  state  is  not  in  the  least 
suspected. 

Lost  to  view,  apparently  forever,  we  still  find  am- 
ple evidence  of  their  existence  in  their  effects  on  J's 
everyday  life.  The  slightest  difficulty  that  arose 
was  sufficient  to  bring  the  thought  of  suicide  to  her 
mind,  and  if  her  sister  J-n-y  opposed  her  in  anything 
we  often  hear  her  replying  in  some  such  way  as  this  : 
"  Well,  maybe  you  '11  be  sorry.  I  shall  kill  myself. 
Which  would  you  rather  do,  have  me  kill  myself  or 
let  me  do  that  ?" 

That  the  suicide  idea  was  still  comparatively  weak, 
however,  had  not  as  yet  gathered  unto  itself  sufficient 
strength  to  make  its  demands  imperative,  as  subse- 
quently happened,  is  shown  by  the  fact  that  through- 
out this  period  of  fourteen  months  J.  never  once 
attempted  to  kill  herself,  although  she  often  thought 
of  how  she  would  do  it,  and  when  would  be  the  best 
time. 

At  the  end  of  this  period,  in  the  month  of  March, 
J.    had   a   difficulty  with    her   brother    H.     She   up- 


Origin  and  Growth  of  Dissociation       139 

braided  him  for  the  way  in  which  he  managed  her 
parents'  estate,  in  which  she  had  an  interest  as  heir, 
under  the  law.  He  told  her  that  if  she  did  not  like 
his  way  of  doing  she  could  get  out.  This  made  her 
very  angry,  and  she  went  to  her  grandmother's  and 
stayed  for  several  days. 

One  night  while  at  her  grandmother's,  and  after 
she  had  gone  to  bed,  she  kept  thinking  about  the 
trouble  she  had  had  with  her  brother,  and  about  what 
as  she  supposed  was  his  mismanagement  of  the  estate. 
Then  the  events  of  the  railroad  accident  came  to  her 
mind  and  with  them  the  reasons  she  had  at  that  time 
for  thinking:  that  her  brother  hated  her.  With  these 
recollections  was  associated  the  old  idea  of  suicide. 
While  she  was  turning  all  these  things  over  in  her 
mind  the  idea  suddenly  flashed  upon  her  that  she 
would  kill  her  brother.  She  thought  of  how  she 
would  do  this,  and  concluded  that  she  would  use  his 
revolver,  as  she  knew  where  it  was  kept,  and  that  it 
was  loaded.  She  felt  confident  that  she  could  ac- 
complish her  purpose  by  going  to  his  room  at  night, 
as  he  was  a  very  sound  sleeper. 

This  is  the  first  occasion  on  which  the  idea  of  hom- 
icide ever  occurred  to  her  ;  an  idea,  the  origin  of 
which,  like  that  of  the  suicide  idea,  became  immedi- 
ately dissociated,  passing  into  the  depths  of  the  sub- 
conscious. 

Although  the  events  surrounding  the  origin  of  this 
idea  were  not  nearly  so  startling  as  those  surrounding 


i4°  Psychopathological  Researches 

the  origin  of  the  suicide  idea,  yet  it  must  be  re- 
membered that  the  habit  of  dissociation  had  already 
been  formed.  The  soil  was  in  a  favorable  condition 
for  the  growth  of  additional  dissociated  ideas. 

Further  than  this  we  see  that  a  somewhat  different 
principle  is  involved  in  the  origin  of  the  homicide  idea 
from  that  which  governed  the  origin  of  the  suicide 
idea.  The  latter  was  directly  suggested  by  the  old 
woman's  story  and  the  events  which  followed,  while 
the  former  came  about  rather  as  a  contrast  idea.  The 
genesis  of  the  homicide  idea  was  purely  subjective, 
and  not,  as  in  the  case  of  the  suicide  idea,  due 
to  objective  agencies  in  the  patient's  environment. 
The  homicide  idea  followed  the  suicide  idea  on  the 
well  known  principle  of  association  of  ideas  by 
contrast. 

During  the  following  year  no  particular  event 
of  importance  occurred.  The  suicide  and  homicide 
ideas  held  the  field  and  gained  considerably  in 
strength.  In  fact,  they  forced  themselves  on  her  at- 
tention at  all  times  and  in  all  places,  and  finally 
came  to  occupy  her  mind  almost  continuously. 

The  suicide  idea  frequently  gave  origin  to  such 
expressions  as  it  had  formerly,  but  the  homicide  idea 
she  kept  carefully  to  herself. 

That  the  suicide  idea  in  particular  gained  in  strength 
and  became  more  imperative  to  its  demands  for  recog- 
nition is  evidenced  by  the  fact  that  once  during  this 
period  she  made  an  abortive  attempt  at  self-destruction. 


Origin  and  Growth  of  Dissociation       141 

She  started  for  the  river  fully  intending  to  jump  in 
and  drown  herself,  but  changed  her  mind,  however, 
only  after  she  reached  the  river's  bank. 

During  this  period  certain  other  symptoms  de- 
veloped which  are  of  great  significance.  She  became 
very  forgetful  ;  so  much  so  in  fact  that  the  common- 
est acts  of  her  life  were  much  interfered  with.  If 
her  sister  J-n-y  would  send  her  for  something  in 
an  adjoining  room  she  would  often  forget  while  on 
her  way  what  it  was,  or  even  go  to  the  wrong 
room,  so  quickly  would  her  sister's  instructions  slip 
from  her.  This  was  such  a  constant  feature  of  her 
condition  that  her  sister  used  often  to  say,  "  Well ! 
you  'd  forget  your  head  if  it  was  n't  tied  on,"  and 
"Why  J.,  you  act  as  if  you  die}  n't  know  what  you 
were  about  half  the  time." 

The  tendency  to  dissociation  was  becoming  more 
and  more  marked.  Dissociation  was  actually  taking 
place.  The  soil  was  being  prepared  for  the  growth 
of  dissociated  systems  conditioned  by  the  events 
which  followed. 

Just  one  year  after  J's  trouble  with  her  brother 
she  met  and  became  attached  to  G.,  a  young  man 
who  had  just  been  employed  at  her  uncle's  mills. 
This  was  an  event  of  some  importance,  largely,  as  we 
shall  see  later,  because  her  attachment  was  bitterly 
opposed  by  the  members  of  her  family. 

About  this  time  she  began  to  have  considerable 
trouble   with    her    eyes.     She   suffered    from    severe 


H2  Psychopathological  Researches 

headaches  almost  every  evening,  largely  as  a  con- 
sequence of  having  to  use  them  so  much  at  school. 
She  was  accordingly  sent  to  N.  to  consult  an  ophthal- 
mologist, who  prescribed  a  pair  of  glasses  for  her 
which  helped  her  for  a  time. 

The  next  July  she  was  sent  by  her  folk  to  visit 
her  Aunt  B.,  who  lived  in  the  pleasant  little  village 
of  G.  on  Long  Island  Sound.  She  was  sent  here 
ostensibly  because  of  the  condition  of  her  health, 
in  reality,  however,  to  break  off  her  relations 
with  G. 

While  here  she  suffered  a  great  deal  from  head- 
aches and  consulted  a  physician  who  told  her,  as  near 
as  she  can  recollect,  that  she  had  astigmatism  and 
inflammation  of  the  eye  muscles,  but  that  back  of  it 
all  there  was  some  brain  trouble. 

She  stayed  in  G.  until  the  holidays,  at  which  time 
she  returned  to  her  home  for  a  period  of  six  weeks. 
During  these  six  weeks  we  see  the  strongest  evi- 
dence of  the  strength  to  which  the  suicidal  idea  had 
attained  in  four  distinct  attempts  at  self-destruction, 
each  of  which  was  much  more  desperate  in  character 
than  the  one  already  described. 

Once  she  took  about  a  half-ounce  from  a  bottle 
labelled  "  poison  "  and  which  afterwards  proved  to  be 
laudanum.  This  made  her  very  sick  and  she  vomited. 
Again  she  drank  from  a  bottle  taken  from  the  medi- 
cine closet  but  no  effect  seems  to  have  been  produced. 
Twice  she  started  to   take  chloroform   but  on   both 


Origin  and  Growth  of  Dissociation       143 

occasions  was  interrupted  and  her  attempt  thereby 
frustrated. 

During  all  this  time,  however,  her  mind  was  almost 
constantly  occupied  by  the  idea  of  suicide,  especially 
when  she  was  left  alone  in  the  house,  as  frequently 
happened. 

During  this  period  of  six  weeks  the  third  important 
event  in  the  history  of  J's  case  occurred.  One  even- 
ing unknown  to  her  folk  she  attended  a  party  with 
G.  While  there  a  young  man,  jealous  of  his  in- 
tended, who  persisted  in  dancing  with  some  one  else, 
shot  himself  in  the  head  and  fell  dead.  Although  J. 
did  not  see  the  tragedy  she  heard  the  shot  fired  and 
was  much  shocked  by  it  and  afterward  by  seeing  the 
dead  man's  body,  bathed  in  its  own  blood,  lying  on 
the  floor  in  the  room  where  she  had  left  her  wraps. 

J.  was  greatly  shocked  (psychical  traumatism)  by 
the  occurrence.  On  that  particular  evening  she  was 
so  nervous  that  G.  remarked  the  fact  on  his  way  home 
with  her,  and  we  shall  have  occasion  from  now  on  to 
note  the  serious  effects  which  this  unfortunate  affair 
had  upon  her.  It  is  certainly  not  to  be  wondered  at 
that  the  effects  were  serious.  It  would  be  strange, 
indeed,  if  such  a  shock  could  be  experienced  by  one 
in  her  condition  without  a  deep  impression  being  left. 

A  few  days  afterward  J.  wandered  into  the  barn  of 
one  of  the  neighbors,  and  unexpectedly  came  upon  a 
farm  hand  in  the  act  of  killing  a  calf.  She  had  often 
seen  such  sights  before,  and  had  never  experienced 


144         Psychopathological  Researches 

any  particular  emotion  at  them,  but  on  this  occasion 
she  was  much  disturbed.  The  sight  of  the  blood 
frightened  her  and  made  her  feel  uncomfortable  and 
strange.  In  fact  she  experienced  much  the  same  feel- 
ings as  upon  the  occasion  of  the  suicide.  This  ex- 
perience was  repeated  shortly  after  on  the  occasion 
of  her  cleaning  and  dressing  a  couple  of  chickens. 

In  these  experiences  we  see  the  beginning  effects 
of  the  shock  she  had  received  in  the  fear  which  it  had 
engendered  at  the  sight  of  blood.  We  shall  shortly 
see,  however,  that  these  effects  are  to  be  more  far- 
reaching-  and  serious  in  character. 

About  this  time  J's  aunt  B.,  with  whom  she  had 
stopped  at  G.,  moved  to  N.  and  J.  went  with  her. 
While  there  her  aunt  had  the  poor  taste  to  tell  her 
of  the  circumstances  surrounding  the  death  of  her 
mother  in  an  asylum. 

Shortly  after  her  arrival  at  N.,  during  the  latter  part 
of  January,  she  suffered  from  a  severe  attack  of'nose- 
i  bleed.  During  this  attack  everything  appeared  red 
to  her.  She  expresses  it  by  saying  that  it  appeared 
to  her  just  as  if  she  were  looking  through  a  red 
glass.  This  symptom  disappeared  when  the  nosebleed 
stopped,  only  to  reappear  with  a  subsequent  attack. 
This  sensation  of  red  was  disagreeable  and  accom- 
panied  more  or  less  by  a  feeling  of  fear  —  erythro- 
phobia.  From  this  time  on  this  sensation  (as  though 
she  were  looking  through  a  red  glass)  appeared, 
especially  when  her  head  ached,  and  as  she  suffered 


Origin  and  Growth  of  Dissociation       145 

from  this  source  a  great  deal  the  sensation  was 
naturally  present  a  considerable  portion  of  the  time. 

In  February  following  she  was  quite  ill  with  a 
severe  attack  of  la  grippe  which  kept  her  confined 
to  her  bed  for  two  weeks.  During  this  period  also 
the  red  sensation  recurred  from  time  to  time. 

The  first  day  out  of  bed  after  her  illness,  she  was 
quite  weak,  and  went  and  lay  down  on  a  sofa  in  an  up- 
stairs room.  While  lying  there  her  mind  reverted 
to  the  occasion  of  the  suicide,  and  again  the  red  sen- 
sation made  its  appearance.  In  connection  with  the 
events  of  the  party,  she  also  thought  of  how  her  folk 
had  scolded  her  for  attending  it,  and  of  her  uncle's 
threat  to  place  her  in  a  convent  if  she  did  not  behave 
better.  These  thoughts  worried  her  greatly.  She 
arose  from  the  sofa,  but  immediately  felt  faint  and 
dizzy  and  fell  to  the  floor,  striking  her  head  on  the 
occipital  region  (physical  traumatism).  Her  fainting 
was  probably  caused,  in  part  at  least,  by  the  pain  of 
menstruating.  (She  not  infrequently  used  to  faint 
away  during  her  menstrual  period.) 

The  fall  was  so  severe  as  to  render  her  unconscious 
and  she  lay  on  the  floor  until  her  aunt  came  upstairs 
and  found  her  and  put  her  to  bed.  When  she  came  to 
she  immediately  began  fighting  her  aunt  and  was  ap- 
parently quite  out  of  her  head.  During  that  after- 
noon she  came  to  herself  for  two  or  three  hours  only, 
lapsing  again  into  her  previous  condition  and  continu- 
ing thus  for  the  following  three  and  one  half  days. 


1 46         Psychopathological  Researches 

During  all  this  time  she  acted  strangely,  often  did 
not  know  where  she  was  or  recognize  those  about 
her.  On  the  third  day  of  the  attack  she  was  taken 
home,  and  on  the  afternoon  of  the  fifth  day  suddenly 
came  to  herself,  with  absolutely  no  recollection  of 
what  had  occurred.  The  last  thing  she  remembered 
was  lying  on  the  sofa  in  her  aunt's  house  at  N.  From 
then  on  everything  was  a  complete  blank,  even  her 
journey  home  having  left  no  trace  in  her  memory. 

This  was  the  first  attack  of  what  we  shall  hereafter 
call  her  secondary  state,  a  condition  from  which  she 
rallies  with  absolutely  no  recollection  of  the  events 
that  occurred  during  its  ascendancy. 

That  the  blow  which  produced  this  state  of  affairs 
was  a  severe  one  is  shown  by  the  fact  that  she  was 
rendered  unconscious  by  it,  and  further  that  when 
she  came  to  her  head  was  paining  severely  in  the  oc- 
cipital region  and  the  point  where  she  struck  was  sore 
and  tender  to  the  touch  for  some  time  afterwards. 
The  fall  also  caused  an  epistaxis  which  continued  in- 
termittently for  four  days — the  most  severe  nose-bleed 
she  had  ever  had. 


CHAPTER  III 

THE  DEVELOPMENT  OF  THE  SECONDARY  STATE 

From  this  first  attack  the  development  of  a  second- 
ary state  was  assured  and  it  accordingly  began  to  mani- 
fest itself  with  ever-increasing  frequency.  It  will  be 
instructive  if  we  pause  and  study  the  origin  of  a  few 
separate  attacks  and  learn  how  this  condition  was 
brought  about  and  what  symptoms  accompanied  its 


-,-• 


/* —      /  V"'  f 


FIGURE  18. 

Graphic  representation  of  J's  abnormal  mental  states. 

incidence.  We  can  do  this  to  better  advantage  if  we 
will  first  pause  and  examine  the  accompanying  dia- 
gram (Figure  18),  which  is  an  attempt  at  the  graphic 
representation  of  J's  abnormal  mental  states. 

If  by  this  diagram  we  represent  J's  stream  of 
consciousness,  then  p  —  that  portion  between  the 
middle  and    upper  line  —  will   represent    her  upper 

147 


H8         Psychopathological  Researches 

or  personal  consciousness,  and  s  —  that  portion  be- 
tween the  middle  and  lower  line — will  represent  her 
subconsciousness.  By  w  is  intended  to  indicate  that 
abnormal  element  in  patient's  consciousness  which  is 
alternately  active — m,  c;  or  dormant — x.  This  is 
termed  "  the  psychopathic  wave." 

When  the  psychopathic  wave  is  active  and  it  cul- 
minates in  the  upper  consciousness  as  at  m,  J.  is 
profoundly  depressed,  inactive,  and  melancholy,  and 
possessed  by  the  idea  of  suicide.  The  origin  of  this 
emotional  condition  is,  however,  in  the  subconscious 
dissociated  mental  states  which  lie  at  the  base  of  the 
wave  at  d — i.e.,  the  story  of  the  suicide  told  her  by  the 
old  woman,  and  which  she  has  long  since  forgotten. 

When  the  psychopathic  wave  is  dormant,  as  at  x, 
the  emotional  state  is,  not  normal  as  we  might  ex- 
pect, but  one  of  pronounced  exaltation.  J.  is  happy, 
laughing,  and  talkative,  and  constantly  active — e. 

When,  however,  the  psychopathic  wave  culminates 
in  the  subconsciousness — c,  J.  passes  into  her  sec- 
ondary state,  and  her  upper  consciousness,  as  indi- 
cated by  the  broken  line  at  /,  is,  in  large  part  at 
least,  inactive. 

Thus  we  see  that  J.  has  three  distinct  abnormal 
mental  states,  viz. :  depressed — m,  exalted — e,  and 
secondary — c.  The  two  former  have  to  do  with  her 
upper  or  personal  consciousness,  although  the  first 
has  its  origin  in  the  subconscious;  the  third  has  to 
do  almost  wholly  with  the  subconscious. 


The  Secondary  State  H9 

On  one  occasion  she  felt  tired  and  lay  down  to  take 
a  nap.  She  was  suffering  from  pain  in  her  head  at 
the  time — the  same  sort  of  pain  that  resulted  from 
her  fall.  J.  has  two  varieties  of  headaches  ;  one  is 
frontal  and  due  to  eye  strain,  the  other  is  occipital 
and  the  result  of  her  fall.  The  former  she  speaks  of  as 
"  headache,"  the  latter  as  "  pain  in  the  head."  It  was 
this  latter  variety  from  which  she  suffered  on  this 
occasion.  While  sleeping  she  dreamt  that  she  visited 
her  uncle's  mills  (woollen  mills),  and  that  there  they 
were  at  work  dyeing  an  unusual  amount  of  red 
cloth,  so  that  there  were  large  quantities  of  this  red 
cloth  all  about  her.  She  awoke,  but  in  her  secondary 
state. 

Other  attacks  were  preceded  in  the  same  way  by 
occipital  pain  and  this  sensation  of  red  without  the 
incidence  of  the  sleep  state. 

Here  we  see  the  development  of  what  appear  to  be 
two  distinct  auras,  both  sensory,  which  usher  in  the 
secondary  state. 

If  we  analyze  these  attacks  carefully,  however, 
especially  with  reference  to  her  condition  before  the 
head  injury,  we  will,  I  think,  have  the  conclusion 
forced  upon  us  that  the  occipital  pain  sensation  is  the 
only  true  aura  of  the  secondary  state.  This  pain  has 
a  constant  relation  to  the  secondary  state,  whereas 
the  red  sensation  not  only  often  occurs  without  the 
pain,  but  was  frequently  in  evidence  before  the  head 
injury,  and  therefore  before  she  ever  had  any  secondary 


i5°         Psychopathological  Researches 

states.  The  red  sensation  is  rather  an  indication  of 
the  activity  of  the  dissociated  subconscious  systems 
occurring  typically  in  connection  with  the  mental 
state — m  (see  Figure  18),  and  quite  consistently  ap- 
pearing on  the  scene  preceding  the  secondary  state, 
when  these  systems  are  about  to  usurp  the  field  of. 
consciousness. 

Let  us  study  still  further  how  these  attacks  mani- 
fested themselves  under  other  conditions. 

One  day  while  at  her  uncle's  house,  her  cousin  L. 
played  on  the  piano  to  her  while  they  sat  together  in 
the  parlor  downstairs.  During  the  playing  she  was 
thinking  of  what  she  had  been  told  she  did  in  her 
secondary  state  and  worrying  about  her  uncle's  threat 
to  send  her  to  a  convent.  After  her  cousin  had 
played  for  a  while  they  went  upstairs  to  her  room. 
As  they  passed  through  the  upper  hall  J.  noticed 
that  the  carpet  was  red.  This  immediately  brought 
back  to  her  mind  the  recollection  of  the  suicide  and 
produced  a  peculiar  feeling  of  fear, — erythrophobia, — 
which  was  immediately  followed  by  pain  in  the  back 
of  her  head.  They  went  together  into  L's  room  and 
L.  read  to  her.  J.,  meanwhile,  was  lying  down,  her 
eyes  shut  (condition  favorable  for  the  outcropping  of 
subconscious  states),  and  thinking  of  the  party  and 
the  subsequent  scolding  her  brother  and  sister  gave 
her.  It  was  during  the  reading  that  the  secondary 
state  asserted  itself.  She  was  thinking  of  her 
brother's  anger,  and  opening  her  eyes  she  mistook  L. 


The  Secondary  State  151 

for  her  brother  and  said,  "  Why  H.,  what  are  you  mad 
at  me  for?"  Her  uncle  took  her  home  and  when  she 
came  to  herself  her  brother  was  untying  her  necktie 
preparatory  to  putting  her  to  bed. 

Another  attack  was  preceded  by  a  dream  of  the 
suicide,  during  which  dream  she  had  both  the  red 
and  pain  sensations.  She  awoke  in  her  secondary 
state. 

During  all  this  time  she  suffered  a  great  deal  from 
headache.  She  would  often  lie  down  complaining 
bitterly  of  her  head,  saying,  "  Oh,  how  my  head 
hurts!"  Then  as  the  secondary  state  would  assert 
itself  she  would  keep  right  on  making  this  remark. 

From  now  on  attacks  were  much  more  frequent. 
They  came  almost  every  day,  and  sometimes  more 
than  one  a  day.  Their  resemblance  to  "  epilepsy  of 
the  psychic  type  "  became  even  more  marked.  Often 
she  would  seat  herself  to  play  on  the  piano,  would 
begin  all  right,  when  a  secondary  state  would  assert 
itself  and  she  would  commence  to  play  one  thing 
after  another  in  a  confused  jumble.  On  one  occasion 
she  started  to  set  the  table  for  dinner,  an  attack  came 
on,  and  she  went  on  with  the  work  but  mixed  up 
everything  hopelessly.  She  then  went  into  the  sitting- 
room  and  sat  down  for  a  few  moments,  then  returned 
to  the  dining-room  and  finished  setting  the  table,  but 
was  greatly  surprised  to  see  how  everything  was 
strewn  over  it,  and  wondered  how  such  a  condition 
had  come  about. 


152         Psychopathological  Researches 

More  interesting  yet  are  the  attacks  during  which 
she  held  conversations  with  her  brother.  They  came 
on  often  when  she  was  seated,  sometimes  alone,  some- 
times with  people  about  her  with  whom  she  was 
conversing.  If  she  had  been  conversing  she  would  sud- 
denly become  quiet  for  a  few  moments,  then  looking 
up  would  mistake  some  one  in  the  room  for  her 
brother,  and  enter  into  conversation  with  them.  This 
would  last  a  few  moments,  when  she  would  suddenly 
come  to  herself  and  resume  her  former  conversation. 

Even  when  no  one  was  in  the  room  with  her  these 
attacks  assumed  the  same  characteristics.  She  would 
then  imagine  that  she  saw  her  brother  before  her,  ad- 
dress remarks  to  him,  and  hear  him  answer  her.  She 
would  usually  talk  to  him  of  suicide,  and  his  replies  to 
her  were  of  a  nature  to  dissuade  her  from  such  an  act. 

Here  we  have  a  condition  closely  bordering  on  that 
of  "double  consciousness";  its  relation  to  so-called 
"  psychic "  epilepsy  is  shown  by  being  in  each  in- 
stance preceded  by  the  aura  previously  described  ; 
its  real  character,  however,  is  that  of  mental  dissoci- 
ation, the  pi'-esence  of  dissociated  systems  in  the  depths 
of  the  subconscious. 

It  was  at  this  time  when  her  attacks  were  recurring 
with  such  frequency  —  during  which  she  was  often 
violent,  having  to  be  held,  on  one  occasion  breaking 
out  the  window  panes  (subconscious  angry  state), 
threatening  and  attempting  suicide  —  that  she  was 
examined  and  committed  as  insane. 


CHAPTER   IV 

THE    SYNTHESIS    OF    THE    DISSOCIATED    STATES 

The  principle  followed  in  this  case  was  that  of 
bringing  together, — re-associating — what  had  become 
dissociated  :  synthesis  of  the  dissociated  subconscious 
states.  All  the  details  of  the  events  for  which  the 
patient  was  amnesic  were  thoroughly  traced  by  use  of 
hypnosis  and  hypnoidization,  and  were  then  united 
to  her  upper,  personal  consciousness,  so  that  she  is 
now  in  full  possession  of  all  of  the  facts.  These 
facts,  obtained  from  her  in  this  way,  were  sub- 
sequently verified  by  numerous  conversations  with 
different  members  of  her  family. 

It  is  noteworthy  in  this  connection,  that  all  of  her 
acts  and  sayings  which  had  previously  seemed  to  have 
no  foundation  in  reason,  but  on  the  contrary  had 
every  appearance  of  being  quite  incoherent,  could  be 
traced  in  each  instance  to  an  adequate  cause,  and  thus 
what  appeared  as  chaos  on  the  surface  was  reduced 
to  order. 

The  hypnotic  state  itself  is  an  abnormal  state,  a 
state  of  dissociation,  and  so  long  as  amnesia  for  this 
state  was  permitted  to  exist  the  patient  could  not  be 
said  to  be  well,  as  the  very  conditions  were  present 

153 


154  Psychopathological  Researches 

which  would  favor  further  tendencies  to  dissociation, 
and  although  the  individual  symptoms  for  which  she 
came  under  treatment  had  disappeared  it  was  highly 
probable  that  they  would  reappear  or  that  others 
would  take  their  place.  When  dissociation  has  once 
begun,  the  dissociated  state  tends  ever  to  gather  unto 
itself  new  material  and  in  growing  to  bring  all  its  ele- 
ments into  systematic  and  ever  more  fixed  relations 
with  one  another.  This  process,  while  enriching  the 
subconsciousness,  does  so  by  robbing  the  upper  con- 
sciousness, thus  bringing  the  patient  more  and  more 
fully  under  the  control  of  the  dissociated  systems. 

In  order  to  prevent  the  possibility  of  these  untoward 
results  the  hypnotic  states  were  dealt  with  in  pre- 
cisely the  same  manner  as  her  secondary  states  and 
brought  into  relation  with  the  upper  consciousness. 

The  results  of  this  method  were  most  gratifying. 
An  immediate  and  marked  improvement  took  place. 
The  erythrophobia  and  the  suicidal  obsession,  which 
did  not  yield  to  the  influence  of  hypnotic  suggestion, 
entirely  disappeared  and  sank  at  once  into  the  back- 
ground. It  is  noteworthy  also  that  the  occipital 
pain,  a  pain  of  apparently  purely  psychic  origin,  also 
disappeared. 

It  was  hardly  to  be  expected,  however,  that  habits 
of  thought  which  were  of  three  and  one  half  years' 
growth  could  be  dissolved  and  made  to  disappear  in  an 
instant  as  if  by  magic,  and  as  a  matter  of  fact  this  did 
not  take  place,  but  from  the  time  when  the  first  re- 


Synthesis  of  Dissociated  States         155 

association  of  subconscious  states  was  effected  to  the 
present  J.  has  been  gradually  though  surely  gravi- 
tating back  to  normal. 

The  suicidal  idea  being  the  most  firmly  fixed  and 
highly  organized  was  correspondingly  the  most  re- 
fractory and  a  slight  tendency  to  its  recurrence  con- 
tinued for  some  time,  indicating  that  J.  was  not 
entirely  well.     It  no  longer  occurred  spontaneously 

■L.-E:  B.B. 


SKEEL'S  SELFRECORDING  PtRlMETE 


FIGURE  19. 


as  formerly,  but  only  as  the  result  of  a  definite  cause  : 
either  some  depressing  event  in  her  environment  or 
as  the  result  of  fatigue.  When  it  did  recur,  however, 
it  was  relatively  less  intense  or  if  intense  was  of 
relatively  short  duration. 

At  this  point  it  will  be  interesting  if  we  compare 
J's  field  of  vision  taken  at  this  time  (see  Figure  19) 
with  her  field  as  it  was  when  she  came  under  observa- 


156  Psychopathological  Researches 

tion  (see  Figure  17).  The  very  great  increase  that 
has  taken  place  is  at  once  apparent.  At  the  time  this 
field  was  taken,  all  symptoms  of  cutaneous  anaesthesia 
had  also  disappeared.  This  indicates  a  condition 
which  I  have  found  to  be  true  in  other  cases,  viz., 
that  the  extent  of  anaesthesia  is  often  an  index  of  the 
extent  of  mental  dissociation. 

The  improvement  in  J's  emotional  sphere  is  evi- 
denced by  a  disappearance  of  that  marked  instability 
so  characteristic  of  her  case  originally,  and  also  of 
the  alternating  states  of  depression  and  exaltation. 
The  latter  have  merged,  as  it  were,  into  an  emotional 
state  of  medium  quality. 

Intellectually  her  improvement  is  marked  by  greater 
stability  and  less  frequent  symptoms  of  fatigue.  It 
is  my  opinion  that  this  condition  of  fatigue  is  very 
frequently  the  necessary  precondition  for  the  forma- 
tion of  dissociated  states.  J.  rarely  complains  of  this 
symptom  now,  but  when  she  first  came  under  treat- 
ment a  conversation  of  but  a  few  minutes  was  sufficient 
to  produce  it.  The  improvement  in  this  particular  is 
partly  due  to  increased  general  health,  but  chiefly,  I 
think,  to  an  equalization,  by  re-association,  of  the 
energy  of  the  systems  of  psychic  neurons. 

On  August  29,  1 901,  J.  left  the  hospital  for  her 
home  on  thirty  days'  parole.  At  the  expiration  of 
this  time,  viz.,  on  September  28,  1901,  she  was  dis- 
charged.    Since  that  time  I   have  been  in  constant 

o 

correspondence  with  her,  and  have  every  reason  for 


Synthesis  of  Dissociated  States         157 

believing  that  she  is  perfectly  well  in  every  way.  I 
can  do  no  better  in  closing  this  review  of  her  case 
than  to  quote  from  a  letter  received  from  her  and 
dated  October  3,  1901.     She  says,  in  part: 

"  R M ,  N.  Y. 

October  3,  1901. 
"  Dear  Dr.  White  : 

Your  letter  received,  and  was  glad  to  hear  from 
you. 

It  seems  good  to  be  home  again. 

My  memory  is  real  good  now,  and  is  better  than  it 
has  been  in  some  time.  We  had  examinations  last 
week,  and  I  stood  the  highest  of  any  one  in  my  grade 
in  geography,  drawing,  and  grammar  ;  so  I  guess  my 
memory  is  not  very  bad.  There  is  no  school  this 
week,  as  it  is  Institute  week. 

I  have  been  selling  the  Life  of  McKinley,  and  I 
sold  twenty-seven  books. 

I  went  chestnutting  to-day  and  rode  four  miles  on 
my  wheel,  and  did  all  the  housework,  so  J-n-y  could 
sew. 

I  am  thinking  some  of  going  over  to  see  J.  B.  this 
week. 

I  had  a  nice  letter  from  Miss  I.  the  other  night, 
telling  me  all  about  her  trip  to  the  Pan-American. 

One  of  the  girls  took  her  father's  horse  and  took 

me  to  G e  to  canvas  for  Life  of  McKinley,  but 

there  had  been  an  agent  all  around  up  there ;  but  as 
it  was  I  sold  three." 


158  Psychopathological  Researches 

I  have  never  seen  that  picture  of  you  that  you  said 
I  might  have.      I  would  be  much  pleased  to  receive  it. 

I   have  just  been   up  to  the  factory,  and  I  weigh 

127^  lb. 

Remember  me  to  all. 

Your  friend, 

J-" 


Mental   Dissociation   in    Depressive 
Delusional   States 


By 

Boris  Sidis 


CHAPTER  I 

THE    HISTORY    AND    THE    FORMED    DELUSION 

From  the  standpoint  of  abnormal  as  well  as  normal 
psychology  the  following  observations  and  experi- 
ments on  what  may  be  regarded  as  a  typical  case  of 
melancholia  present  many  points  of  interest  to  the 
student  of  psychology  and  psychopathology. 

The  patient  is  a  Russian  Jew ;  he  is  twenty-six 
years  of  age,  and  by  occupation  a  clerk.  He  is  quite 
intelligent  and  is  temperate  in  his  habits.  His  physi- 
cal constitution  up  to  the  time  of  his  illness  was 
strong  and  healthy,  except  that  he  seemed  to  have 
had  a  severe  attack  of  malaria.  He  had  no  mental 
anxiety,  suffered  from  no  worry  ;  and  from  his  tem- 
perament and  race  one  could  be  tolerably  sure  that  he 
never  indulged  in  any  excesses. 

The  family  history  could  not  be  well  ascertained, 
but  from  the  patient's  account  it  appeared  that  he  was 

159 


160  Psychopathological  Researches 

of  good  stock,  his  parents  as  well  as  his  nearest 
relatives  being  all  of  a  good  healthy  constitution. 

About  February,  1900,  the  patient  began  to  suffer 
from  headaches,  insomnia,  and  loss  of  appetite.  The 
patient  found  he  could  not  fix  attention  on  anything, 
his  mind  wandering  aimlessly ;  he  could  not  retain 
anything  in  his  memory.  He  began  to  feel  gloomy, 
depressed,  and  dejected  in  spirits ;  he  avoided  com- 
pany, having  a  desire  to  be  left  alone  ;  his  physical 
health  became  greatly  deteriorated  ;  his  appetite  was 
getting  poorer ;  his  bowels  were  costive,  and  he  suf- 
fered from  great  pain  in  the  abdomen. 

The  patient  called  on  one  of  the  local  physicians, 
who,  on  examination,  referred  the  whole  trouble  to 
the  stomach  and  to  the  intestinal  tract  and  indiges- 
tion. To  bring  the  matter  home  to  the  patient  the 
physician  told  him  he  had  "  lumps."  From  this  time 
dates  the  definite  manifestation  of  the  disorder.  The 
incautious  statement  was,  so  to  say,  the  last  straw  that 
broke  the  camel's  back.  These  "  lumps  "  proved  the 
nucleus  of  a  complicated,  highly  organized  systematized 
delusion.  The  patient  formed  the  fixed  delusion  that 
a  vast  amount  of  waste  materials  in  the  form  of  lumps 
had  become  accumulated  in  his  intestines.  This  de- 
lusion developed  further  and  became  minutely  worked 
out.  The  mass  of  lumps  was  regarded  by  the  patient 
not  as  being  stationary,  but  as  spreading  to  other 
organs  of  the  body,  continually  shifting  position  and 
taking  many  courses  in  different  directions.     These 


History  and  the  Formed  Delusion       161 

courses  were  minutely  described  and  localized  by  the 
patient.  The  lumps  seemed  to  have  kept  a  course 
of  their  own  ;  in  the  form  of  minute  spots,  they 
streamed  to  the  head  and  came  out  in  a  definite  hole 
in  the  thigh.  These  were  the  main  streams  ;  minor 
currents  circulated  through  various  other  organs, 
finally  coming  to  the  same  holes.  This  formed  the 
basis  of  the  delusion. 

On  this  delusional  basis  was  superimposed  a  highly 
complicated  delusional  superstructure.  The  patient 
believed  he  had  worms  in  the  intestines  ;  it  was  these 
worms  working  on  the  great  amount  of  lumps  that 
broke  the  big  hard  lumps  and  ate  them  ;  at  the  same 
time  being  stupid  and  careless,  they  sprinkled  tiny 
lumps  all  about  them.  It  was  this  sprinkling  that 
gave  rise  to  the  different  currents  in  various  directions. 
The  worms  were  regarded  by  the  patient  as  not 
unfriendly  agents  ;  in  fact,  they  were  useful  in  break- 
ing up  the  stuff  of  the  lumps  and  eating  away  his 
waste  materials  as  much  as  they  could.  The  only  ob- 
jection to  the  worms  was  the  process  of  sprinkling 
which  sent  tiny  lumps  circulating  through  the  body. 
In  this  process  of  sprinkling,  due  to  the  careless 
mode  of  "  feasting,"  the  worms  themselves  became 
besprinkled  with  tiny  lumps  and  were  very  uncom- 
fortable, but  they  could  not  free  themselves  from  the 
lumps  which  stuck  fast  to  their  slimy,  sticky  bodies. 
The  more  the  greedy  worms  ate,  the  more  did 
they  become  besprinkled  with  tiny  lumps  in  a  most 


1 62  Psychopathological  Researches 

disgusting  fashion,  and  the  more  uncomfortable  they 
felt.  Were  he  dependent  on  the  agency  of  these 
stupid  worms  alone  the  patient  believed  he  would 
have  been  in  a  very  bad  fix  indeed  ;  he  would  have 
simply  become  chock-full  of  these  tiny  lumps,  and 
there  would  have  been  an  end  of  him.  Fortunately 
for  himself  as  well  as  for  the  worms,  three  agencies 
came  to  the  rescue  of  this  intolerable  state  of  affairs, 
—  the  spleen,  the  soul,  and  the  veins.  The  veins 
took  a  passive  part,  but  the  soul  was  specially  active 
in  removing  the  lumps  as  fast  as  possible  as  well  as 
taking  directions  from  its  more  intelligent  com- 
panion, the  spleen.  The  worms  were  now  taken  in 
hand  by  the  soul  and  cleansed  of  their  fast  accumu- 
lating lumps,  which  were  taken  up  by  the  veins  and 
driven  in  definite  currents  to  the  two  main  holes  of  the 
body.  The  spleen  and  the  soul  were  the  two  active 
agents  in  this  purifying  process.  The  soul  was  the 
scavenger  and  the  spleen  the  director.  This  was 
rather  an  unusual  function  for  the  soul,  but  the 
patient  did  not  find  it  degrading,  and  was  rather  glad 
that  the  soul  had  undertaken  this  highly  useful  func- 
tion. Although  the  situation  was  sad  and  deplorable, 
still,  under  the  circumstances,  the  patient  considered 
that  nothing  better  could  have  happened. 

With  the  soul  as  scavenger-in-chief  and  the  spleen 
as  superintendent  the  state  of  things  was  by  no  means 
cheerful.  Things  dragged  on  ;  the  worms  at  first  were 
very  angry  at  being  handled,  but  then  they  felt  com- 


History  and  the  Formed  Delusion       163 

fortable  as  they  were  cleaned  quite  carefully  by  the  soul 
under  the  constant  watchful  direction  of  the  spleen ;  the 
patient,  however,  felt  as  uncomfortable  as  ever.  A 
whole  system  of  signs  was  established  between  the  two 
scavengers,  the  soul  and  the  spleen,  signs  which  the 
patient  could  hear  distinctly.  He  could  hear  the  spleen 
grunt  in  reply  to  the  signals  given  to  it  in  a  sort  of 
deaf  and  mute  fashion  by  the  ever-waking,  never-tiring 
soul.  The  spleen  would  grunt  when  the  soul  worked 
well,  but  its  grunt  did  not  resemble  that  of  "  man." 

The  worms  in  their  stupid  way  were  piling  up  work, 
for  the  poor  soul.  The  patient  believed  that  he  could 
distinctly  feel  the  soul  come  and  go  and  open  the 
mucous  membrane  and  clean  up  the  worms,  which  at 
first  quite  resented  such  an  operation,  appreciating  it, 
however,  in  the  end  and  acquiescing  in  the  process  of 
this  unceremonious  handling. 

The  good,  efficient  work  of  the  soul  depended  a  great 
deal  on  the  intensity  of  the  attention.  When  there 
was  nothing  to  distract  the  attention,  the  patient 
believed  that  he  could  feel  the  soul  going  round  in  its 
silent  way  and  cleaning  away  all  his  lumps  from  the 
head  into  the  veins  and  then  to  the  stomach.  When, 
however,  his  attention  became  distracted,  the  soul  did 
not  work  well ;  the  spleen  then  by  signs  commanded 
the  soul  to  stop  ;  the  soul  did  not  and  could  not 
answer,  but  it  understood  and  ceased  its  activity. 
When  the  patient  was  asleep  the  cleaning  activity  of 
the  soul  came  to  a  complete  standstill. 


CHAPTER  II 

A    REVIEW    OF    THE    GENERAL    PSYCHOMOTOR    STATES 

The  emotional  state  of  the  patient  was  one  of  great 
depression  and  even  of  anxiety  ;  the  face  looked  ex- 
tremely sad,  anxious  and  distorted  with  the  mental 
pain  caused  by  the  lumps  and  the  three  working 
agencies, — the  worms,  the  spleen,  and  the  soul.  The 
eyes  were  lustreless,  apathetic  ;  the  skin  was  pale  ;  the 
whole  body  was  badly  nourished  and  partly  bent,  as  if 
by  the  weight  of  great  suffering. 

The  feelings  of  the  patient  were  greatly  affected  ; 
he  lost  all  interest  in  everything  and  in  everybody. 
His  whole  mental  and  emotional  horizon  became 
narrowed  down  to  the  one  painful  state,  to  his  highly 
systematized  delusion.  He  became  unfit  to  do  his 
work  and  he  had  to  give  it  up  altogether.  The  para- 
sitic delusional  system  became  the  predominating  one 
and  sapped  all  the  vigor  of  his  affective  emotional 
life. 

His  mind  seemed  to  have  become  a  blank  to  every- 
thing else,  or  as  he  put  it :  "I  looked  and  could  not 
see."  Like  a  mental  cancer  the  delusional  system 
grew  and  developed  at  the  expense  of  the  life  of  other 
normal  mental  systems.      Whatever  was  possible  to 

164 


Psychomotor  States  165 

connect  with  this  central  delusion  was  greedily  seized 
and  organized  into  its  tissue  ;  what  could  not  lend  it- 
self to  such  a  purpose  was  rejected,  ignored,  in  some 
way  or  other  transformed  into  an  illusion  so  as  to  fit 
the  system  and  then  absorbed  and  organized.  The 
delusion  formed  the  focus,  the  very  heart  of  the 
patient's  life. 

The  flow  of  association  of  ideas  became  greatly 
retarded  and  even  seemingly  arrested ;  only  what 
related  to  the  principal  delusional  system  and  what 
therefore  met  with  no  obstruction,  only  that  alone 
flowed  with  great  ease  and  facility.  The  patient 
could  hardly  be  induced  to  talk  of  anything  else  but 
his  woe  ;  when  he  was  induced  to  enter  into  conversa- 
tion his  speech  was  slow  and  in  monosyllables ;  the 
thoughts  formed  slowly,  with  great  difficulty,  and 
tended  to  revert  to  the  principal  delusional  system. 
Only  when  the  conversation  directly  concerned  the 
dominating  delusion,  only  then  did  the  current  of 
speech  and  the  stream  of  association  of  ideas  flow  with 
ease  and  without  disturbance. 

While  the  patient's  memory  was  otherwise  bad  and 
unreliable  the  memories  for  his  delusion  were  excellent 
and  exact  to  the  last  trifling  details.  Outside  his  main 
delusional  system  the  reasoning  process  was  sound 
and  but  little  disturbed.  The  trouble  was  that  but 
little  mental  material  remained  outside  this  delusion ; 
most  of  it  having  been  drawn  into  the  whirlpool  of 
the  general  delusional  state. 


1 66  Psychopathological  Researches 

The  attention  was  impaired  in  relation  to  all  inter- 
ests and  also  to  stimuli  not  connected  with  the  one  all- 
absorbing  delusional  system,  but  it  was  quite  strong 
and  distinct  to  whatever  directly  or  indirectly  con- 
cerned the  focal  functioning  system  constituting  the 
delusion.  The  loss  of  attention  in  regard  to  things  not 
connected  with  the  systematized  delusion,  no  doubt, 
explains  the  fact  of  the  relative  loss  of  memory. 

The  patient  could  not  fix  his  attention  on  anything. 
When  tested  with  readings,  he  could  not  follow  the 
type,  —  he  became  mixed  up  and  understood  nothing 
of  what  he  had  been  reading.  Occasionally  the  de- 
pression became  so  intense  that  he  was  absolutely  in- 
capable of  appreciating  external  impressions,  or  as  the 
patient  characteristically  put  it:  "I  looked  out  of  my 
eyes  and  I  could  not  see." 

The  patient  was  also  predisposed  to  become  pos- 
sessed or  obsessed  by  insistent  ideas  from  which  he 
could  not  free  himself.  Thus,  one  of  his  friends  sug- 
gested to  him  that  he  seek  advice  of  Dr.  N.  This 
suggestion  became  a  fixed  idea  with  him, —  he  must 
see  Dr.  N.  come  what  may.  He  had  no  rest  and 
gave  others  no  rest;  he  implored  over  and  over  again  : 
"  Will  Dr.  P.  go  to  see  Dr.  N.  ;  it  is  in  my  head  and 
I  must  see  him;  it  is  always  in  my  mind  and  it  bothers 
me."  It  was  only  by  means  of  hypnotic  suggestion 
that  we  could  rid  the  patient  of  this  insistent  and 
troublesome  idea. 

In  regard  to  the  general  motor  reactions,  no  gross 


Psychomotor  States  167 

motor  disturbances  were  present ;  the  reflexes  re- 
mained normal,  but  the  voluntary  motor  reactions 
were  rather  retarded  ;  the  patient  reacted  slowly  to 
external  stimulations,  walked  at  a  slow  pace,  as  if  ab- 
sorbed in  one  intense,  painful  grief.  The  whole  motor 
attitude  was  decidedly  one  of  dejection.  As  in  the 
case  of  memory  and  attention  the  motor  reaction  be- 
came quickened  with  regard  to  impressions  relating  to 
the  delusion. 

No  sensory  disturbances  were  present.  Sensory 
stimulations  were  correctly  perceived  and  estimated  ; 
no  anaesthesia,  no  paresthesia,  no  hyperesthesia  could 
anywhere  be  detected.  Vision  remained  unaffected  ; 
there  was  no  limitation  of  the  field  of  vision  ;  and 
there  was  no  reversion  in  the  series  of  perceived 
colors.  Taste,  smell,  touch,  pressure,  the  thermic 
sense,  and  kinesthetic  sensibility  were  all  in  good 
condition  and  showed  not  even  transient  anomalies. 

The  patient  suffered  from  bad  dreams,  which  also 
left  him  in  a  state  of  great  depression  after  awaking. 
The  dreams  usually  referred  to  the  delusion  and 
seemed  to  have  intensified  it.  Thus,  during  the  early 
part  of  his  illness  he  used  often  to  dream  of  his  spleen, 
and  has  seen  it  in  his  sleep  jumping  around  and  re- 
moving lumps.  One  night  he  became  so  terrified 
that  he  screamed  in  his  sleep,  from  which  he  awoke 
in  great  terror  ;  he  was  afraid  that  his  spleen  would 
jump  out  through  his  chest.  Sometimes  his  dreams 
were  determined  not  by  the  definite  delusion,  but  by 


1 68  Psychopathological  Researches 

the  general  indefinite  melancholic  tone.  Once  he 
dreamt,  for  instance,  of  two  men  attempting  to  mur- 
der him  and  that  he  called  firemen  to  his  aid. 

No  hallucinations  were  present,  and  the  illusions 
observed  were  those  pertaining  to  the  dominating  de- 
lusion, which  was  of  a  purely  central  character  ;  no 
peripheral  pathological  disturbances  could  in  any  way 
justify  it,  except  possibly  the  condition  of  costiveness, 
which  was,  no  doubt,  of  a  secondary  character  in  the 
formation  of  the  delusional  system. 

Although  the  affective  states  were  of  intense  de- 
pression, still  there  was  no  tendency  to  self-destruc- 
tion. The  whole  attitude  was  one  of  quiet,  passive 
dejection,  without  any  violent  outbursts,  without  any 
uncontrollable  impulses. 

It  goes,  of  course,  without  saying  that  orientation 
in  space,  time,  and  in  regard  to  social  relations  was 
fully  and  clearly  present  and  as  far  as  it  could  be  as- 
certained was  never  gone.  The  patient  could  fully 
realize  his  environment,  he  could  come  to  definite 
places  at  the  appointed  time,  and  could  take  good 
care  of  himself.  The  central  delusion  was  entirely 
limited  to  his  inner  life,  and  seemed  not  to  have 
affected  his  relation  to  the  external  world ;  it  left  in- 
tact his  sense  of  appreciation  of  his  environment.  As 
far  as  examination  could  disclose  neither  unconscious- 
ness nor  subconscious  states  have  occurred  in  his 
former  normal  healthy  condition  or  in  the  course  of 
his  mental  disease. 


Psychomotor  States  169 

The  intensity  of  emotional  depression,  the  retarda- 
tion of  psychomotor  processes,  and  the  highly  syste- 
matized delusion  of  the  agencies  conceived  in  his 
physical  troubles  would  have  made  it  tolerably  cer- 
tain to  a  psychiatrist  that  the  case  closely  approxi- 
mated to  typical  hypochondriacal  melancholia,  and 
some  even  would  have  added  that  the  case  had  a 
strong  tendency  to  what  may  be  termed  "secondary 
paranoia." 


CHAPTER  III 

THE    PHENOMENA    OF    AFFECTIVE    TRIPLE     PERSONALITY 

If  now  from  the  waking  state,  strongly  tinged  as  it 
is  with  hypochondriacal  melancholia,  we  turn  to  the 
patient's  subconsciousness,  we  are  confronted  with 
a  totally  different  state  of  things.  No  sooner  did  the 
patient  pass  into  trance  than  a  profound  change  sud- 
denly swept  over  his  whole  being.  A  metamorphosis 
almost  instantly  took  place  in  him.  The  intense 
misery  of  the  melancholic  state  completely  disappeared 
and  instead  of  it  a  state  of  intense  euphoria  emerged. 
No  greater  change  could  possibly  be  conceived. 
The  patient's  face  became  radiant  with  happiness  and 
lighted  up  with  smiles ;  he  could  not  utter  a  word 
without  grinning  and  laughing  with  delight  for  the 
very  joy  of  living.  As  far  as  affective  states  were 
concerned  a  new,  totally  different  personality  seemed 
to  have  emerged  from  the  depths  of  the  subconscious. 

In  spite,  however,  of  the  profound  change  of  the 
whole  affective  tone  and  of  the  emotional  states  the 
focal  delusion  persisted  as  much  as  ever  and  appeared 
to  be  far  more  definite  in  its  outline,  far  better  organ- 
ized in  its  constitution.  The  affective  state  of  de- 
pression was  gone  and  an  opposite  state  of  well-being 

170 


Triple  Personality 


171 


appeared,  and  still  the  delusion  remained  in  its  full 
force.  This  clearly  pointed  to  the  fact  that  the  delusion 
could  well  exist  without  the  emotional  melancholic 
state,  and  that  either  the  state  of  depression  was  of 
secondary  formation  brought  about  by  the  gradual 
organization  of  the  systematized  delusion,  or  that  the 
delusion,  though  being  of  secondary  origin,  had 
gained  sufficient  strength  and  independence  to  stand 
by  itself,  even  when  the  emotional  basis  of  depression 
was  completely  withdrawn.  In  any  case,  the  fact 
remained  that,  notwithstanding  the  change  of  the 
affective  and  emotional  states  to  their  very  opposite 
and  contrasting  conditions,  the  delusion  remained  as 
firm  as  ever. 

The  trance  personality,  happy,  contented,  though 
still  delusional,  as  far  as  the  general  mental  state  was 
concerned,  approximated  more  closely  to  the  patient's 
normal  self  before  the  mental  trouble  set  in  than  the 
highly  hypochondriacal  waking  self.  Although  there 
was  such  a  profound  change  in  the  emotion  of  the 
trance  personality,  as  contrasted  with  the  waking  con- 
dition, there  was  absolutely  no  change  in  the  content 
of  memory.  The  trance  and  the  waking  state  were 
bridged  over.  In  his  trance  the  patient  could  vividly 
remember  all  that  had  taken  place  in  his  waking  life. 
On  the  other  hand,  in  his  waking  state  the  patient 
could  recollect  all  that  had  transpired  during  hypnosis, 
though  this  occurred  not  without  some  effort.  The 
memory  was  rather  indistinct  and  was  far  from  being 


172  Psychopathological  Researches 

vivid,  the  recollection  appearing  more  in  the  nature  of 
dream  memory,  being  vague  and  indistinct,  arid  could 
only  be  made  clear  by  fixation  of  the  attention. 

Later  on,  when  in  one  of  his  subconscious  states, 
the  patient  passed  into  a  still  deeper  trance,  and  to 
our  great  surprise  the  whole  affective  emotional  tone 
of  the  trance  state  with  which  we  have  become  famil- 
iarized vanished,  and  a  new  emotional  personality 
emerged.  The  metamorphosis  was  a  very  marked 
one  ;  the  change  from  one  personality  to  the  other 
was  radical.  From  being  happy,  smiling,  gay,  and 
full  of  inexpressible  delight,  the  whole  attitude 
changed  to  one  of  quiet,  composed,  and  even  of  grave 
demeanor.  Things  were  not  accepted  in  that  easy- 
going fashion,  with  smiles  and  laughter,  but  were 
rather  taken  seriously  and  earnestly.  The  change 
that  passed  over  the  patient's  countenance  in  his  pass- 
ing from  one  stage  of  trance  into  another  and  deeper 
one  was  extremely  interesting  to  watch.  It  seemed 
as  if  from  the  depths  of  subconscious  mental  life  a 
new  person  with  absolutely  different  qualities  and 
characteristics  came  to  the  surface  of  consciousness. 
The  transformation  was  striking,  and  this  change  was 
all  the  more  wonderful  as  the  whole  process  took 
place  rapidly.  Not  the  least  trace  of  sadness  and  de- 
jection was  left.  The  whole  attitude  of  the  trance 
personality  breathed  a  quiet,  composed  contentment. 
The  contrast  to  the  melancholic  waking  personality, 
full  of  unutterable  misery,   and  the  antithesis  to  the 


Triple  Personality  173 

first  trance  personality,  merry,  easy-going,  and  full  of 
unspeakable  bliss,  could  not  be  more  complete. 

If  the  change  was  great  in  the  life  of  feeling  and  in 
the  emotional  expression  and  attitude,  the  modifica- 
tion in  the  function  and  content  of  memory  was  still 
greater.  The  last  trance  personality  could  remember 
clearly  and  distinctly  all  experiences  of  the  first  trance 
personality,  and  also  those  of  the  waking  personality, 
but  neither  the  waking  nor  the  first  trance  person- 
ality knew  anything  of  the  second  trance  personality. 
There  were  thus  three  personalities,  each  with  its 
own  moods  and  emotional  states,  with  its  own  content 
and  function  of  memory,  but  with  the  same  persistent 
and  stably  organized  delusion.  The  waking  person- 
ality was  melancholic  and  mentally  diseased,  with 
a  narrowed-down  content  of  psychic  material.  The 
trance  personalities  were  comparatively  healthy  and 
with  a  wider  and  deeper  content  of  mental  life,  with 
a  greater  activity  of  psychic  functions  than  the  wak- 
ing personality  ;  each  succeeding  personality  being 
wider  and  more  comprehensive  than  the  one  that  had 
preceded  it.  As  far  as  pure  function  of  memory  is 
concerned,  the  interrelation  of  the  three  personalities 
may  be  represented  by  a  series  of  concentric  circles, 
the  two  trance  personalities  being  designated  by  B 
and  C  according  to  the  order  of  their  appearance. 
Designating  the  successive  personalities  by  A,  B,  C, 
— A  standing  for  the  waking,  B  for  the  first  and 
C    for    the    second    trance    personality, —  then    their 


174  Psychopathological  Researches 

inter-relations  are  such  that  while  C  has  access  to  A 
and  B,  B  has  access  to  A,  but  not  to  C. 

In  respect  to  memory  the  phenomena  follow  the 
general  law  of  personality  interconnection  :  Out  of  a 
series  of  interconnected  personalities  the  functions  of 
reproduction  and  recognition  are  retained  by  the  ones 
rich  in  psychic  content  and  lost  by  the  ones  the 
psychic  content  of  which  is  poor  and  limited.    Memory 


FIGURE  20. 

thus  is  proportional  to  the  amount  of  retained  psychic 
content  ;  this  usually  follows  in  the  order  of  the  depth 
of  the  uncovered  psychic  strata.  Personalities  spon- 
taneously formed  at  a  deeper  subconscious  level 
are  the  most  comprehensive  and  have  the  best  mem- 
ory. Amnesia  rttns  parallel  to  the  ascent  of  psychic 
states. 

On  the  affective  and  emotional  side  the  gap  between 
one  personality  and  another  was  far  greater  than  on 


Triple  Personality  1 75 

the  side  of  memory.  The  three  personalities,  the 
melancholic,  the  exalted,  and  the  grave,  stood  out 
clear  and  distinct  in  their  outlines.  Each  personality 
emerged  with  its  own  distinctive  affective  physiog- 
nomy, the  one  passing  into  its  opposite,  not  by  tran- 
sitional stages,  but  by  abrupt  termination  with  the 
emergence  of  one  of  the  sharply  outlined  personalities. 
The  affective  emotional  traits  and  characteristics  did 
not  intermingle  to  form  a  complex  whole,  but  kept 
distinct  and  separate  in  their  synthetic  quasi-personal 
unity. 

The  waking  personality  and  the  first  trance  person- 
ality may  be  regarded  as  contrast  personalities  and 
may  possibly  be  referred  to  the  same  fundamental 
relation  of  contrast  effects,  prevalent  in  mental  life 
whether  in  the  domain  of  sense  or  in  that  of  emotion. 
Of  the  three  personalities  the  waking  is  pathological, 
the  first  trance  personality  is  exaltant  though  nearer 
to  the  normal,  while  the  sedate,  contented  second 
trance  personality  approaches  as  nearly  as  possible  to 
the  patient's  healthy  condition. 

It  is  well  here  to  point  out  the  fact  that  these  sharply 
defined  personalities  form  by  no  means  a  unique  phe- 
nomenon ;  their  course  runs  closely  parallel  to  the 
well-known  circular  insanities  of  which  folie  a  double 
forme  may  possibly  be  regarded  as  most  closely  re- 
sembling in  type  the  present  case.  In  the  different 
forms  of  circular  insanities  we  meet  with  just  such 
contrasting  states, — a  state  of  depression,  a  state  of 


176  Psychopathological  Researches 

'exaltation,  and  an  intermediary  more  or  less  normal 
condition.  These  states  are  of  longer  or  shorter 
duration,  varying  differently  in  the  order  of  succession 
with  each  individual  case. 

The  analogy  of  this  case  with  the  general  course  of 
melancholia  may  even  be  a  closer  one.  It  has  been 
observed  that  in  the  course  of  melancholia,  when  the 
patient  is  on  the  way  to  recovery,  before  he  returns  to 
his  fully  normal,  healthy  state,  a  stage  of  slight  exalta- 
tion is  passed  through,  due  no  doubt  to  results  of 
contrast  effects.  The  three  personalities  in  our  case 
present  parallel  conditions  and  a  similar  order  of  suc- 
cession to  that  observed  in  the  course  of  typical  mel- 
ancholia. The  succession  of  the  three  states  or  of 
the  quasi-personalities  was  of  the  same  order,  namely, 
the  melancholic,  the  exaltant,  and  the  quiet, — the 
normal.  In  the  fully  normal  individual  a  similar 
course  of  succession  of  contrasting  emotional  states 
is  observed.  When  relieved  from  an  intense  state  of 
grief  or  anxiety,  we  pass  temporarily  into  a  state  of 
exaltation  before  we  settle  down  into  our  previous 
normal  state  bearing  the  marks  of  the  outlived  ex- 
periences. 


CHAPTER    IV 

THE    PSYCHOGENETIC    LAW 

These  alternating  personalities,  however,  were  but 
ephemeral ;  the  process  of  regular  alternation  was  but 
of  brief  duration.  At  first  the  patient  had  to  pass 
through  the  exaltant  stage  in  order  to  reach  the  level 
of  the  second  trance  personality  ;  soon  the  first  trance 
personality  was  observed  to  shrink  in  its  dimensions 
and  duration  and  finally  disappeared  altogether,  the 
patient  passing  from  the  melancholic  waking  state 
directly  into  the  state  of  the  second  trance  personal- 
ity. This  first  trance  personality  never  reappeared  ; 
its  constituent  elements  seemed  to  have  become  dis- 
solved and  fused  with  the  second  subconscious  per- 
sonality. As  a  matter  of  fact  one  could  clearly 
observe  that  the  mood  of  the  second  subconscious 
personality  became  far  more  cheerful  and  had  lost 
somewhat  of  its  pristine  gravity  and  sedate  content- 
ment. 

This  dropping  out  of  the  first  subconscious  person- 
ality was  already  observed  in  the  reverse  process  of 
ascent  from  the  deeper  levels  of  the  subconscious 
back  to  the  upper  levels  of  waking  life.  In  coming 
out  of  the  deeper  states  of  subconsciousness  from  the 

12  I77 


178  Psychopathological  Researches 

strata  of  the  second  personality  formation,  the  patient 
returned  directly  to  the  waking  state  without  first 
passing  through  the  intermediary  levels  of  the  first 
subconscious  personality.  With  the  repetition  of  the 
series  in  its  downward  and  upward  course,  this  in- 
termediary first-personality  stage  became  shortened, 
shrank  more  and  more,  and  finally  was  blended  and 
fused  in  a  condensed  form  with  the  last  phase  of  the 
process,  with  the  second  subconscious  personality. 

The  patient's  states  and  the  cycles  with  the  stages 
through  which  he  passed  may  be  graphically  repre- 
sented by  the  following  diagrams  : 


FIGURE   21. 

Let  A, A  (Figure  21)  represent  the  content  of 
the  stream  of  the  melancholic  waking  consciousness ; 
the  waves  a,a  represent  mental  states  of  the  upper 
stream.  Although  the  waves  and  the  states  they 
designate  are  not  the  same,  still  for  the  sake  of  clear- 
ness and  precision  they  are  termed  the  a,a  waves  and 
the  designated  states  the  a,a  states. 


B( 


FIGURE  22. 

In  Figure  22,  B,B  represent  the  subconscious  con- 


The  Psychogenetic  Law 


i/9 


tent  of  the  first  trance  stratum  and  the  waves  b,b 
some  of  its  mental  states.  The  waves  are  termed 
the  b,b  waves  and  the  designated  states  the  b,b 
states. 


FIGURE  23. 


In  Figure  23,  C,C  represent  the  subconscious 
stratum  in  which  the  second  trance  personality  has 
become  developed,  the  mental  states  of  which  are 
represented  by  the  waves  c,c.  The  waves  of  the 
second  trance  personality  belonging  to  the  last 
stratum  are  termed  the  c,c  waves  and  the  designated 
states  the  c,c  states. 

The  patient,  in  passing  from  the  waking  state 
through  the  strata  of  the  first  and  second  trance  per- 
sonalities, then  from  the  second  trance  personality 
through  the  first  trance  personality  back  to  the  waking 
state,  passes  through  a  cycle  which  maybe  termed  the 
psychopathic  cycle.  This  cycle  is  indicated  by  its  cor- 
responding curve  which  may  be  termed  the  psycho- 
pathic curve. 

The  relations  of  memory  content  of  the  various 
mental  states  are  indicated  by  the  areas,  or  better  to 
say  by  the  volume,  of  the  waves ;  thus  the  wave  b 


180  Psychopathological  Researches 

possesses  its  own  content  and  reproduces  that  of  the 
waking-  state  A,  A.  The  wave  falls  short  of  the  stratum 
C,C,  and  cannot  reproduce  the  content  of  the  second 
trance  personality.  The  c,c  waves  of  the  stratum  C,C 
possess  their  own  content  and  reproduce  the  content 
of  the  waking  and  first  trance  states  belonging  to  the 
strata  A,  A  and  B,B.  The  a,a  waves  of  the  waking 
stratum  reproduce  partially  and  imperfectly  the  con- 
tent of  the  6,6  waves,  the  power  of  reproduction  fail- 
ing with  the  progress  of  the  psychopathic  process  and 
the  frequent  repetition  of  the  cycles.  The  a,a  waves 
are  completely  cut  off  from  all  access  to  the  c,c  waves 
with  their  special  content  coming  from  the  subcon- 
scious stratum  B,B. 

The  psychopathological  process  regarded  as  a 
whole  passed  through  five  stages  which,  though  im- 
perceptibly merging  one  into  the  other,  were  still 
distinctly  marked. 

In  the  first  stage,  the  a,a  waves  of  the  stratum  A,  A, 
representing  the  upper  consciousness,  were  alone 
functioning.  Only  the  melancholic  states,  the  a,a 
states,  were  present     (Figure  21). 

In  the  second  stage,  the  6,6  waves  representing  the 
6,6  states  of  the  stratum  of  the  first  trance  personality 
were  brought  into  active  function,  forming  a  cycle 
a6a  (Figure  22). 

In  the  third  stage,  the  c,c  waves  and  c,c  states  of 
the  stratum  of  the  second  trance  personality  began  to 
function,  giving  rise  to  the  cycles  a6c6a  (Figure  23). 


The  Psychogenetic  Law 


181 


The  patient  had  to  pass  through  the  b,b  states  in 
order  to  enter  the  c,c  states  of  the  second  trance  per- 
sonality, and  on  emerging  from  the  c,c  states  the  b,b 
states  were  passed  through  again  before  the  a,a  states 
of  the  upper  waking  consciousness  could  be  reached. 

In  the  fourth  stage,  the  patient  reached  the  c,c 
states  through  the  b,b  states,  but  on  emerging  from 
the  c,c  states  the  b,b  states  were  omitted,  the  patient 
rising  directly  to  the  a,a  states,  the  cycle  becoming 
abbreviated  to  abca  (Figure  24). 


FIGURE  24. 

In  the  fifth  stage,  the  b,b  states  were  altogether 
eliminated,  the  patient  passing  directly  from  the  a,a 
states  into  the  c,c  states,  and  then  back  again  into  the 
a,a  states,  the  cycle  becoming  reduced  to  aca  (Figure 

2  5)- 


FIGURE  25. 

The  process  of  abbreviation  in  this  case  is  the  gen- 
eral course  usually  taken  by  series  of  subconscious 


j  82  Psychopathological  Researches 

personalities.  In  a  concatenation  of  a  series  of 
subconsciously  formed  personalities,  the  tendency  is 
towards  condensation.  The  intermediary  links  are 
dropped  or  suppressed  in  most  of  the  detail  traits 
and  are  incorporated  with  the  last  members  of  the 
series,  which  become  more  prominent  in  proportion 
to  the  frequency  of  repetition  of  the  series  as  a  whole. 
The  last  members  of  the  series  grow  and  develop  by 
the  process  of  assimilation  of  the  intermediary  links. 
The  tendency,  in  short,  is  toward  omission  of  the 
intermediary  personalities  and  toward  survival  of 
the  lastly  organized  personalities.  Such  personalities 
may  become  stable  and  form  the  guiding,  controlling 
personages  of  the  dramatic  interplay  characteristic  of 
the  highly  developed  subconscious  life  activity. 

This  process  of  elimination  is  no  doubt  of  the  same 
order  as  that  found  to  be  characteristic  of  psychic 
activities  in  general.  In  the  compounds  of  sensory 
elements,  both  primary  and  secondary,  in  the  fusion 
of  feelings,  and  in  the  flow  of  association  of  repre- 
sentations and  ideas  we  meet  with  a  tendency  toward 
condensation,  toward  abbreviation  of  intermediary 
links,  toward  formation  of  "  short  cuts,"  so  to  say. 

Thus  the  memory  process  is  really  an  abbreviation 
of  the  past  experiences.  In  reviewing  the  past,  a  good 
many  of  the  details  are  suppressed ;  only  the  general 
outlines,  with  the  most  important  and  essential  features 
of  outlived  experiences,  are  preserved.  A  life  of  years 
is  reviewed  in  a  mental  glance  of  a  few  moments. 


The  Psychogenetic  Law  183 

Were  it  not  for  this  process  of  abbreviation,  for  this 
dropping  out  and  elimination  of  most  of  the  details 
and  preservation  of  the  most  general  essential  outlines 
embodied  in  the  last  act  of  recollection,  it  would  re- 
quire a  lifetime  to  recall  our  life  experiences.  Memory 
would  be  a  burden.  Only  on  condition  of  suppres- 
sion, of  elimination,  of  abbreviation  of  most  of  the 
details  in  past  series,  only  on  condition  of  forgetful- 
ness,  can  mental  life  grow  and  develop.  Memory 
foreshortens  the  past ;  it  looks  at  what  has  gone  by 
through  the  other  end  of  the  telescope,  so  to  say.  In 
this  respect,  the  process  of  recollection  closely  re- 
sembles that  of  conception,  which  is  a  highly  symbolic 
representative  summary  of  past  sensations,  percep- 
tions, and  representations.  Memory  is  a  symbolic 
epitome  of  the  past. 

Something  parallel  we  find  in  biological  series 
where  the  formation  of  a  species  is  brought  about  by 
extinction,  the  extermination  of  the  intermediary  vari- 
eties and  by  the  survival  of  the  last  links  of  the  series, 
which  in  a  condensed  form  represent  the  main  traits 
of  the  so-called  "  missing  links."  The  process  of  evo- 
lution of  species  and  genera  is  one  great  illustration 
of  this  process  of  elimination  of  intermediary  links. 
In  the  evolution  of  the  individual,  we  meet  once  more 
with  a  similar  process  of  condensation,  inasmuch  as 
the  development  of  the  particular  organism  presents 
a  condensed  and  abbreviated  history  of  the  stages 
passed  through  by  its  ancestors  in  the  long  course  of 


184  Psychopathological  Researches 

organic  evolution  ;  or,  as  it  is  often  expressed  in  the 
well-known  biogenetic  law,  that  ontogeny  is  an  abbre- 
viation or  an  epitome  of  phylogeny. 

Evolutionary  series  seem  to  be  conditioned  on  this 
process  of  elimination  and  condensation  of  inter- 
mediary links  ;  it  is  economy  of  time  and  energy  and 
makes  possible  further  development.  The  biogenetic 
law  holds  good  of  all  biological  and  psychological 
evolutionary  processes.  However  the  case  may  be, 
the  fact  remains  that  the  first  trance  personality  was 
suppressed  and  entirely  disappeared,  the  patient  pass- 
ing from  the  waking  state  directly  into  the  condition 
of  the  second  trance  personality,  a  fact  characteristic 
of  all  intermediary  subconscious  personalities, — their 
fate  being  to  come  and  vanish  from  the  scene  of  life, 
without  ever  gaining  a  firm  hold  on  the  life-existence 
of  the  individual. 


CHAPTER  V 

THE    POWER    OF    ASSIMILATION    OF    THE    DOMINANT 
SYSTEM 

Most  remarkable  was  the  curious  fact  that  through- 
out these  affective  and  emotional  changes,  throughout 
these  subconscious  upheavals,  formations,  transforma- 
tions, and  disappearances  of  personalities,  the  central 
delusion  remained  unshaken.  New  psychic  material, 
however  trivial,  was  immediately  seized  on  and  incor- 
porated into  this  all-absorbing  system.  This  highly 
organized  system  could  possibly  be  best  compared  to 
an  animal  with  a  limitless  appetite. 

From  the  psychological  and  psychopathological 
standpoints  of  the  theory  of  moment-consciousness  this 
great  power  of  assimilation  is  extremely  interesting. 
As  this  is  not  a  suitable  place  to  discuss  the  subject 
of  moment-consciousness,  we  limit  ourselves  to  a  bare 
mention  of  its  important  theoretical  aspects,  which 
are  developed  in  a  forthcoming  work,  The  Principles 
of  Psychology  and  Psychopathology. 

What  specially  concerns  us  here  is  the  experi- 
mental side  showing  the  great  assimilating  power  of 
this  highly  organized  delusional  system.  Sugges- 
tions, motor  and  sensory,  were  given  to  the  patient 

185 


1 86  Psychopathological  Researches 

during  his  different  subconscious  states ;  they  were 
taken  and  carried  out  only  in  so  far  as  they  could  be 
assimilated  by  the  dominating  delusion,  otherwise 
they  were  simply  rejected.  The  suggestion  developed 
gradually  in  proportion  to  its  gradual  absorption  and 
incorporation  into  the  guiding  delusional  system 
brought  into  relation  to  the  "lumps"  and  "spots." 
Thus  in  one  of  the  hypnotic  states  a  post-hypnotic 
suggestion  was  given  to  the  patient  that  on  awaking  he 
would  see  a  black  cat.  One  of  the  black  weights  which 
the  patient  used  in  the  fatigue  experiments  was  put 
opposite  him  so  that  the  post-hypnotic  hallucination 
should  be  easily  realized,  the  false  perception  taking 
the  character  of  an  illusion,  the  black  weight  serving 
as  a  suggestion  and  nucleus  for  the  realization  of  the 
suggested  hallucination.  When  the  patient  awoke 
from  his  trance  he  remembered  vaguely  as  if  he  had 
seen  a  black  cat  in  a  dream  and  that  he  was  to 
see  a  black  cat,  but  he  did  not  see  what  he  looked 
for.  Then  the  weight  attracted  his  attention  and  he 
looked  at  it  fixedly,  and  gradually  the  post-hypnotic 
hallucination  developed,  though  in  an  abortive  form. 
The  patient  smilingly  took  the  weight  in  his  hands, 
but  it  was  no  cat  though  it  had  the  color  of  a  black 
cat ;  then  he  began  to  pat  the  weight  as  if  he  were 
patting  a  cat,  though  he  knew  it  was  no  cat.  After 
patting  the  weight  he  looked  at  it  for  a  long  time 
with  great  attention  and  then  began  to  perform  exer- 
cises with  it  as  in  the  fatigue  experiments,  though  he 


The  Power  of  Assimilation  187 

did  not  know  the  reason  why  he  was  making  these 
movements.  He  was  going  through  this  process  with 
great  zeal  and  satisfaction.  When  asked  why  he  was 
doing  all  that  he  replied,  looking  intently  at  the 
weight,  it  was  good  for  him,  it  helped  draw  off  his 
lumps  and  spots.  The  suggestion  thus  became  ab- 
sorbed and  assimilated  by  the  focal  delusion. 

Another  time  a  similar  post-hypnotic  suggestion 
was  given  to  him,  and  with  precisely  the  same  results. 
The  black  weight  was  substituted  for  the  hallucinatory 
black  cat,  but  the  patient  did  not  realize  the  sug- 
gestion ;  he  did  not  see  the  cat,  but  after  some  time 
he  seized  the  weight  and  began  to  perform  exercises 
with  it,  though  he  could  give  no  reason  for  his  action  ; 
the  only  reason  was  that  it  did  him  good,  it  removed 
his  lumps  and  spots.  In  short,  he  embodied  the  sug- 
gestion into  his  delusional  system. 

In  one  of  his  deep  hypnotic  states,  when  the  patient 
seemed  otherwise  quite  amenable,  he  was  tried  with  a 
post-hypnotic  suggestion  of  a  snake.  The  element  of 
fear,  it  was  thought,  might  make  it  easier  to  have  the 
suggestion  realized  freely  without  any  reference  to  his 
delusional  system.  A  suggestion  was  given  to  the 
patient  that  on  coming  out  from  his  hypnotic  condi- 
tion he  would  see  a  snake  ;  a  rubber  belt  was  put 
before  him  to  serve  as  a  point  de  repere,  so  to  say. 
On  awaking,  the  patient's  eye  was  at  once  fixed  on 
the  belt,  but  the  latter  at  first  gave  rise  to  no  halluci- 
nation whatever  ;  the  mere  word-suggestion  emerged, 


1 88  Psychopathological  Researches 

and  that  in  a  purely  negative  form  :  "  It  is  no  snake," 
he  kept  on  saying.  His  look,  however,  was  constantly 
fixed  on  the  belt,  as  if  the  eye  was  fascinated  by  this 
enchanting  object.  From  the  standpoint  of  gradual 
development  and  realization  of  a  subconscious  post- 
hypnotic suggestion  the  experiment  was  extremely 
interesting,  but  more  so  was  it  from  the  psychological 
point  of  view  of  moment's  power  of  assimilation, 
which  will  be  discussed  in  its  appropriate  place. 

The  patient  kept  on  looking  fixedly  at  the  suggested 
snake,  and  finally  began  to  regard  the  object  with 
great  suspicion.  "  It  looks  like  a  snake,  but  it  must  be 
dead,"  he  said.  Gradually  the  dominating  delusional 
system  began  to  assimilate  the  percept,  and  on  this 
basis  the  suggested  hallucination  began  to  develop, 
and  finally  became  realized,  but  in  a  transformed  con- 
dition fully  in  accord  with  the  overmastering  delusion. 
"  It  looks  dead,"  he  said,  eyeing  the  belt  suspiciously, 
"  but  my  worms  are  alive  ;  this  is  not  alive  ;  it  is  not 
my  vein."  The  patient's  attention  became  more  and 
more  fixed  on  the  belt,  as  if  his  eye  were  riveted  to 
it ;  his  face  assumed  a  puzzled  questioning  look  of 
doubt  and  uncertainty  ;  evidently  he  could  not  decide 
what  in  the  world  that  fascinating  object  could  pos- 
sibly be.  Finally  a  look  of  recognition,  and  also  of 
terror,  could  be  clearly  seen  coming  over  him  ;  the 
percept  was  being  gradually  assimilated  by  the  delu- 
sional system  ;  and  now  the  suggested  hallucination 
began  to  develop  rapidly.      "  I  do  not  know  what  it 


The  Power  of  Assimilation  189 

is,  but  I  am  scared  at  it ;  when  my  vein  came  I  was 
scared  at  it.  That  thing  must  have  come  from  some- 
body, and  I  am  scared  at  it  now.  I  shall  throw  it 
away."  He  threw  the  belt  away,  but  picked  it  up 
soon,  and,  looking  fixedly  at  it,  ended  by  becoming 
really  frightened,  and  concluded  :  "  Maybe  it  is  mine  ; 
it  is  no  snake,  though  ;  I  have  no  snakes."  The 
patient  could  not  see  the  belt  as  a  snake,  because  his 
delusion  was  that  he  was  possessed  by  worms,  not  by 
snakes. 

The  following  experiments  are  still  more  interest- 
ing with  regard  to  the  tendency  towards  systematiza- 
tion  in  the  further  development  of  the  given  suggestion 
brought  in  relation  to  the  fundamental  delusion. 

A  small  chain  of  links  and  small  plates  were  at- 
tached to  the  belt.  This  chain  attracted  the  patient's 
attention.  He  looked  at  the  links  for  some  time  and 
finally  said :  "  I  have  in  my  body  such  pieces  ;  the 
vein  takes  them  up  by  signs  from  the  soul  and  the 
spleen."  The  patient  then  looked  intently  at  the  flat 
pieces  and  evidently  was  puzzled  by  them  and  at  first 
he  said  he  had  nothing  like  them.  The  experience 
evidently  could  not  be  assimilated.  Soon,  however, 
the  negative  aspect  of  this  bit  of  psychic  material 
with  regard  to  the  assimilating  system  changed,  and 
the  patient  doubtfully  and  hesitatingly  declared  that 
the  vein  had  a  mouth  not  unlike  this  flat  plate,  though 
not  just  like  it.  As  he  spoke  his  face  brightened 
up    markedly    and  a  contented    look  of   recognition 


190  Psychopathological  Researches 

passed  over  his  face,  and  he  declared  with  an  air  of 
positive  assurance  that  the  vein  did  have  a  mouth 
very  much  like  these  flat  pieces.  The  suggestion 
was  partially  realized,  being  first  decomposed,  di- 
gested, and  modified  by  the  assimilating  power  of  the 
dominant  delusion. 

The  overwhelming  and  systematizing  power  of  this 
central  delusional  system,  nourished  by  the  delusional 
nucleus,  was  clearly  brought  out  in  the  experiments 
made  on  the  patient  with  the  object  of  developing 
the  phenomena  of  automatism.  The  patient  for  some 
reason  or  other  took  a  great  dislike  to  subconscious 
writing  automatism.  It  was  suggested  that  he  would 
answer  questions  in  subconscious  automatic  writing. 
The  suggestion  was  not  taken.  As  usual  the  patient 
modified  the  suggestion  to  fit  the  delusion,  —  he 
began  to  make  dots  with  the  pencil,  claiming  that 
these  dots  were  his  lumps  and  spots  coming  out  from 
under  his  "mucous  membrane"  and  flowing  through 
the  pencil  on  to  the  paper. 

Whatever  was  possible  was  immediately  pressed 
into  the  service  of  the  delusion.  The  patient  ob- 
served black  spots  under  the  nails  of  the  toes.  These 
black  spots  were  immediately  identified  with  the  de- 
lusional lumps  and  spots.  Another  time,  when  the 
delusional  system  began  to  be  broken  up,  its  vitality 
was  still  clearly  manifested  by  its  remarkable  power 
of  assimilation.  Thus  when  the  patient  was  sitting 
and  looking  at  his  foot  with  the  supposed  delusional 


The  Power  of  Assimilation  191 

spots  in  the  toes,  he  happened  to  feel  the  pulsations 
of  an  artery,  he  immediately  adapted  this  experience 
to  his  delusion.  These  pulsations  were  due  to  the 
spots  continually  flowing  and  running  off  into  the 
hole. 


CHAPTER  VI 

THE    PREDOMINANCE    OF    MOTOR    PSYCHOSIS 

This  firmness  and  stability  of  the  organized  system 
with  the  delusion  as  its  nucleus  were  greatly  in  the 
way  of  the  effective  carrying  out  of  suggestions, 
whether  hypnotic  or  post-hypnotic.  Suggestions 
were  often  altered  beyond  recognition  ;  it  took  time 
before  suggestions  could  be  made  more  or  less  effec- 
tive. Constant  rehypnotization,  repetitions  of  com- 
mands, insistent  injunctions,  numerous  suggestions, 
were  requisite  to  enforce  with  varying  success  some 
form  of  obedience  and  obtain  some  approximately 
satisfactory  results.  In  this  respect  it  is  interesting 
to  note  the  fact  that  suggestions  of  motor  ideas  and 
representations  were  the  first  ones  to  become  amen- 
able to  control  and  were  by  far  the  easiest  to  enforce. 
The  suggestions  of  purely  sensory  representations 
and  ideas  were,  on  the  contrary,  the  most  difficult  to 
control,  and  even  to  the  very  last  their  enforcement 
was  enacted  with  but  partial  success.  Something 
similar  is  observed  in  the  stages  of  hypnosis  :  sensori- 
motor suggestions  are  taken  before  purely  sensory 
suggestions ;  paralysis,  catalepsy,  contractions,  all 
motor  and  kinaesthetic  illusions  and  hallucinations  are 

IQ2 


The  Predominance  of  Motor  Psychosis  193 

usually  very  easily  enforced  even  in  the  very  light 
stages,  while  it  is  only  in  the  deeper  stages  that 
changes  of  sensation  and  perception  can  be  brought 
about.  The  induction  of  illusions  and  hallucinations, 
positive  and  negative,  is  usually  effected  only  in  the 
very  deep  stages  of  hypnosis.  The  striking  feature 
of  the  present  case,  however,  was  the  fact  that 
hypnotic  and  post-hypnotic  suggestions  of  acts  were 
easily  effected,  while  suggestions  of  sensory  illusions 
and  hallucinations  could  not  be  successfully  de- 
veloped ;  they  at  once  fell  a  prey  to  the  dominating 
delusional  system  and  were  either  suppressed  or 
modified  beyond  recognition.  Suggestions,  however, 
such  as  opening  and  closing  the  door  or  lighting 
matches,  were  carried  out  without  any  resistance  or 
even  modifications. 

Still  more  interesting  is  the  fact  that  the  motor 
suggestions  have  also  proved  more  persistent  in  the 
patient's  subconscious  memory.  Thus  motor  memo- 
ries of  fatigue  experiments  emerged  in  post-hypnotic 
hallucinations  and  were  finally  brought  by  the  patient 
into  relation  with  the  dominant  system.  So  persistent 
were  these  subconscious  motor  memories  that  it  was 
by  no  means  easy  to  have  them  dislodged  from  the 
patient's  mind.  The  interesting  fact  about  motor 
suggestions  was  the  great  ease  with  which  they  were 
accepted  and  their  insistent  tendency  to  recur. 

The  ease  of  acceptance  of  motor  suggestions  may 
be  ascribed  to  the  fact  that  ideo-motor  life  is  more 


194  Psychopathological  Researches 

subject  to  changes  from  slight  stimulations  than  sen- 
sory life  :  motor  elements  enter  readily  into  new  com- 
binations. From  a  biological  standpoint  one  can  see 
the  importance  of  the  greater  ease  of  modifiability 
displayed  by  sensori-motor  and  ideo-motor  elements, 
since  in  the  adaptation  of  the  organism  to  its  environ- 
ment it  is  these  elements  that  are  mainly  employed 
in  reaction  to  stimuli  of  the  external  world.  From 
the  standpoint  of  adaptation,  a  slightly  appreciable 
difference  of  sensory  experience  may  give  a  widely 
different  and  highly  complex  motor  reaction. 

Psychomotor  processes  form  the  most  important 
and  largest  portion  of  mental  life.  With  the  exception 
of  man,  all  the  representatives  of  the  animal  kingdom, 
from  the  lowest  to  the  highest  forms,  represent  but 
different  stages  in  the  evolution  of  sensori-motor  life. 
The  great  majority  of  mankind  still  leads  a  life  closely 
allied  to  animal  sensori-motor  states.  Even  in  the 
highest  and  most  developed  forms  of  mental  activity, 
motor  ideas  and  representations  are  by  far  the  most 
predominant.  Without  motor  elements,  ideational 
life  is  arrested.  It  is  these  sensori-motor  and  ideo- 
motor  elements  that  constitute  the  "  stream,  the  flow, 
the  current "  of  our  thoughts.  Motor  elements  enter 
freely  into  combinations  with  all  other  elements  of 
mental  life.  This  freedom  in  forming  new  combina- 
tions and  associations  makes  the  sua-o-estion  of  motor 
ideas  and  representations  highly  effective. 

Throughout  the  scale  of  animal  life  from  the  lowest 


The  Predominance  of  Motor  Psychosis  195 

to  the  highest  forms,  intelligence  is  intimately  related 
to  the  degree  of  development  of  the  muscular  system 
and  the  delicacy  of  its  motor  adjustment.  Among  the 
lower  forms  of  life,  the  Cephalopods  are  well  equipped 
with  powerful  muscular  arms  capable  of  executing  a 
great  variety  of  vigorous  movements.  Now  the  Ceph- 
alopods also  possess  a  more  highly  developed  nervous 
system  with  a  higher  grade  of  mental  functions  than 
the  rest  of  the  Mollusca.  The  great  activity  of  ants 
and  bees  is  notorious  and  their  instinctive  psychic  life 
is  the  richest  among  the  Arthropoda.  Note  the  great 
variety  of  motor  adjustments  of  the  beaver  and  also 
the  intelligence  that  goes  along  with  it.  Birds  pos- 
sessed of  a  high  degree  of  activity  and  motor  adapta- 
bility are  also  the  most  intelligent  of  their  kind,  such 
for  instance  as  the  crow  and  the  different  species  of 
talking  birds.  Notice  the  activity  and  great  agility  of 
the  fox  and  also  the  unusual  cunning  for  which  he  is  so 
celebrated.  The  suppleness  of  the  dog,  his  quick  re- 
actions to  stimulations,  the  resources  of  his  motor 
adjustments,  and  the  great  extent  of  his  modifiability 
under  changing  conditions,  are  all  well  known,  and 
along  with  them  goes  a  high  degree  of  psychosis.  Of 
all  the  Mammals,  the  Quadrumana  are  the  most  active, 
the  most  imitative  and  full  of  mimicry,  and  with  the 
exception  of  man  they  are  also  the  most  intelligent. 
When  we  come  to  man  we  cannot  help  admiring  the 
high  complexity  and  extreme  delicacy  of  his  motor  ad- 
justments.    Most  marvellous,  however,  is  the  human 


196  Psychopathological  Researches 

hand,  that  divine  organ  which  gives  shape  and  form 
to  works  of  art,  to  all  the  outward  visible  manifesta- 
tions of  civilization.  The  great  artists  and  thinkers  of 
antiquity  held  the  human  hand  in  great  reverence. 
One  of  the  great  Greek  philosophers  did  not  even 
hesitate  to  declare  that  man's  superiority  over  the 
brute  was  due  to  his  hand.  Finally  in  the  wonder- 
fully delicate  motor  adjustments  of  speech  we  find 
clearly  illustrated  the  intimate  relation  between  motor 
and  psychic  activities. 

Experiments  prove  the  same  truth  of  the  predomi- 
nance of  motor  ideas  and  representations  in  our  men- 
tal life.  If  a  series  of  syllables  or  numbers  is  given 
to  memorize  after  one  reading,  five  out  of  ten  can  be 
remembered,  though  with  some  difficulty  ;  but  if  the 
syllables  or  numbers  are  written  down  at  the  same 
time,  though  not  looked  at  during  the  writing,  a  far 
greater  percentage,  such  as  six  or  seven  syllables,  can 
be  remembered.  If  the  motor  elements  in  a  train  of 
ideas  are  suppressed,  the  order  of  the  series  becomes 
confused,  and  even  totally  destroyed,  showing  that 
the  motor  ideas  are  important  links  in  trains  of  asso- 
ciation of  ideas. 

Biologically  regarded,  voluntary  activity — will — is 
the  organism's  power  of  adjustment  to  the  conditions 
of  the  external  environment.  In  its  last  psychological 
analysis,  voluntary  activity,  or  will,  consists  of  repre- 
sentations of  various  modes  of  adaptations — that  is, 
of  motor  memories,  of  highly  complex  systems  of  kin- 


The  Predominance  of  Motor  Psychosis  197 

aesthetic  representations  constituting  the  active  sub- 
ject of  the  highly  developed  personality.  If  this  be 
realized,  then  the  vital  importance  of  motor  memories 
cannot  be  too  highly  overrated.  Motor  memories 
are  at  the  very  heart  of  personality.  We  are  what 
we  can  accomplish.  Extreme  variability  and  adapta- 
bility are  the  main  characteristic  traits  of  intelligence, 
will,  personality,  with  their  motor  memories  as  their 
central  nuclei. 

The  readiness  of  psychomotor  elements  and  groups 
to  enter  into  ever  new  combinations  gives  rise  to  the 
formation  of  a  great  wealth  of  associations  which 
help  to  make  the  labile  psychomotor  groups  and  sys- 
tems stable  and  easy  of  recall.  In  fact  it  may  be 
said  that  the  ease  of  recall  is  proportionate  to  the 
mass  of  associated  kinesthetic  memories.  If  under 
the  action  of  adverse  conditions  associations  are 
dropped  or  lost,  many  more  still  remain  to  recall  the 
affected  system,  some  of  the  functional  bonds  of 
which  have  become  loosened.  The  great  wealth  of 
associations  formed  by  motor  memories  brings  about 
their  ease  of  recall,  also  their  recurrence  in  conscious- 
ness even  under  unfavorable  conditions  of  dissocia- 
tion. The  great  modifiability  and  variability  of 
systems  of  motor  memories  requisite  in  the  adaptation 
of  the  organism  to  the  varying  condition  of  its  en- 
vironment make  the  ever  greater  instability  of  motor 
memories  an  imperative  necessity  in  the  struggle  for 
existence. 


i98  Psychopathological  Researches 

Forming  the  predominant  elements,  both  as  to  in- 
tensity and  mass,  of  the  most  complex,  relatively 
stable,  though  ceaselessly  shifting  groups  and  systems 
constituting  the  highly  developed  organization  of  the 
personal  self,  the  motor  elements,  presentative  and 
representative,  are  also  the  first  to  become  involved 
in  the  process  of  dissociation.  I  n  the  various  forms 
of  nervous  and  mental  diseases,  under  different  con- 
ditions of  intoxication  and  auto-intoxication,  in  the 
traumas  caused  by  shock,  physical  or  psychic,  the 
delicate  movements  of  adjustments  are  the  first  to 
become  affected,  dissociations  of  systems  of  motor 
representations  are  first  to  occur  with  their  concomi- 
tant motor  derangements. 

The  instability  of  motor  memories  and  of  psycho- 
motor elements  in  general  may  be  brought  into 
relation  with  the  fact  of  the  early  affection  of  muscular 
and  kinesthetic  sensibilities,  and  with  the  predomi- 
nance of  sensori-motor  over  purely  sensory  symptoms 
so  frequently  occurring  in  the  course  of  nervous  dis- 
eases. With  this  may  be  correlated  the  significant 
fact  referred  to  by  Mosso,  that  "  all  substances  which 
slowly  destroy  the  organism  must  produce  phenomena 
analogous  to  those  of  curari,  since  the  motor  nerves, 
according  to  our  researches,  have  less  vitality  than 
the  sensory."  It  would  be  more  correct  to  substi- 
tute for  "  motor"  the  term  "sensori-motor,"  because 
muscular  and  kinesthetic  sensibilities  are  also  in- 
volved in  the  same  process  of  degeneration.      It  may 


The  Predominance  of  Motor  Psychosis  199 

also  be  observed  in  passing,  that  cellular  kinoplasm 
with  the  "kinocentrum,"  the  centrosome  and  its 
archoplasmic  structures,  possibly  the  most  primitive 
motor  organoids  of  the  cell,  similarly  manifest  a  high 
degree  of  variability  and  instability. 

Motor  memories  may  be  regarded  as  the  labile  ele- 
ments of  consciousness  ;  they  become  easily  and  fre- 
quently dissociated  and  dropped  into  the  subconscious, 
but  for  that  very  reason  they  are  also  very  easily 
reproduced  or  regenerated.  In  this  respect  motor 
memories  follow  the  general  biological  law  of  organic 
regeneration  :  Organs  that  are  easily  and  frequently 
lost  in  the  struggle  for  existence  are  also  easily  re- 
generated, as,  for  instance,  the  legs  and  claws  of 
Crustacea  or  the  tentacles  of  the  starfish  and  the  octo- 
pus. Dissociated  systems  of  motor  memories  often 
become  regenerated  and  under  pathological  conditions 
when  synthesis  is  impossible  they  may  even  recur  with 
great  insistence,  giving  rise  to  the  most  uncontrollable 
types  of  insistent  ideas  and  impulses  and  to  various 
forms  of  so-called  "  psychic  epilepsy,"  especially  of  the 
motor  type,  closely  mimicking  typical  organic  ep- 
ilepsy. Dissociated  subconscious  systems,  like  rudi- 
mentary aborted  organs,  are  very  persistent  and  often 
very  injurious  to  the  organism.  The  recurrence  of  the 
subconsciously  submerged  dissociated  systems  has  its 
parallel  in  the  biological  phenomena  of  reversion,  or 
atavism.  The  development,  growth,  and  recurrent 
persistence   of  a   subconscious  dissociated  system   is 


200  Psychopathological  Researches 

like  a  malignant  sarcomatous  neoplasm  the  cells  of 
which  present  a  reversion  to  the  embryonic  type. 

In  the  present  case,  this  greater  ease  with  which 
suggestions  of  motor  ideas  and  representations  pre- 
dominated and  persisted  in  consciousness  was  specially 
prominent  from  the  very  nature  of  the  mental  malady, 
of  the  hypochondriacal  systematized  delusion.  Ideas 
and  representations  derived  from  the  special  senses 
and  the  great  mass  of  sensations  coming  from  the 
functions  of  the  internal  organs,  from  the  viscera, 
especially  from  the  sympathetic  system,  all  of  which 
play  an  important  role  in  the  formation  of  moods, 
affections,  and  sensations,  have  become  more  firmly 
and  rigidly  systematized  and  organized  into  the  body 
of  the  central  delusion  than  the  freer  and  more  mobile 
psychomotor  elements. 

This  fact,  that  the  psychomotor  elements,  motor 
ideas  and  representations,  enter  more  easily  into 
combinations  and  form  extensive  associative  systems, 
makes  them  easier  of  recall  and  hence  apparently 
more  persistent  in  memory.  From  an  educational 
standpoint,  one  realizes  the  importance  of  this  fact  of 
persistent  recurrence  and  great  ease  of  recall  of  motor 
memories.  Children  learn  and  remember  things  best, 
not  by  abstract  notions,  not  by  looking  at  objects 
and  hearing  of  things,  but  by  acting  out  whatever  is 
taught  them.  Not  only  is  the  interest  increased  on 
that  account  and  knowledge  made  more  vital  and 
better  assimilated,   but  the  content  acquired  is  also 


The  Predominance  of  Motor  Psychosis  201 

far  better  retained  and  more  easily  remembered  ;  it 
emerges  with  greater  ease  and  is  at  the  child's  com- 
mand at  any  time,  because  of  the  nature  of  the 
interwoven  motor  memories.  In  the  training-  of  the 
mentally  defective,  the  best  method  followed  is  that 
of  motor  instruction  ;  the  best  way  of  teaching  the 
mentally  defective  is  to  have  the  ideas  acted  out  and 
from  the  actions  get  at  the  meaning,  even  if  it  be  only 
automatically,  of  what  is  requisite  to  be  learned.  As 
a  matter  of  fact,  even  the  perfectly  normal  and  well 
balanced  mind  gets  at  the  meaning  of  things  by 
handling  them,  by  having  the  attributes  of  the  object 
and  the  processes  of  the  work  to  be  learned  acted 
out.     Acting  forms  the  greater  part  of  man's  life. 

In  giving  suggestions  intended  to  be  persistent  and 
lasting,  their  character  should  be  motor  rather  than 
sensory  ;  the  suggestion  given  should  be  associated 
with  kinesthetic  sensations  and  motor  ideas.  I  have 
often  found  that  when  a  suggestion  is  not  taken,  even 
though  insisting  on  it,  this  same  suggestion  will  be 
effective,  if  the  subject  is  made  to  repeat  it.  The 
auditory  sensory  stimulations  were  not  sufficient ; 
when,  however,  kinesthetic  sensations  and  motor 
ideas  were  interwoven  into  the  suggestion,  it  became 
effective,  and  without  any  insistence  on  the  suggestion. 
When  given  under  such  conditions,  the  suggestion 
was  usually  carried  out  without  any  opposition. 

For  therapeutic  purposes  it  is  certainly  of  impor- 
tance to  have  the  suggestion  as  stable  as  possible.    To 


202  Psychopathological  Researches 

effect  this,  the  best  way  is  to  utilize  this  fact  of  per- 
sistence of  sensori-motor  and  ideo-motor  elements,  of 
the  greater  ease  of  recall  characteristic  of  kinesthetic 
sensations  and  ideas.  The  patient  should  be  made  to 
repeat  orally  the  given  suggestion,  or  to  write  it  out, 
and,  if  possible,  to  act  it  out.  Motor  and  kinesthetic 
sensations  and  memories  make  suggestions  durable. 

It  is,  of  course,  preferable  that  the  associated  motor 
memories  should  not  be  of  a  passive,  but  of  an  active 
character.  To  guide  and  move  the  patient's  limb,  for 
instance,  is  not  as  good  as  when  he  carries  out  the 
acts  of  his  own  accord.  In  other  words,  active  kin- 
aesthetic  associations  are  most  potent  in  suggestion. 
Along  with  other  methods,  the  use  of  kinesthetic 
associations  is  of  the  greatest  value  in  the  process  of 
formation  and  also  of  disintegration  of  a  stably  organ- 
ized system. 


CHAPTER  VII 

SUBCONSCIOUS    DISINTEGRATION    AND    THE    AFFECTIVE 
PERSONALITIES 

The  whole  make-up  of  the  mental  systems  con- 
stituting the  delusion  was  so  firmly  organized,  that 
the  process  of  disintegration  had  to  be  started  from 
various  points  and  worked  in  different  ways.  Since 
the  waking  state  was  of  a  distinctly  melancholic  type, 
in  which  the  central  delusion  was  nigh  inaccessible, 
the  only  way  to  attack  it  was  through  the  subcon- 
scious, which  presented  the  line  of  least  resistance. 
Hypnosis,  and  the  deepest  stage  of  it,  was  the  only 
practicable  way  of  making  any  attempt  at  all  to  break 
up  these  stably  organized  systems  constituting  the 
central  delusion.  Direct  emphatic  suggestion  during 
hypnosis  is  the  most  usual  form  of  disintegrating 
stable  systems,  especially  if  the  latter  belong  to 
the  upper  waking  consciousness.  The  defect,  how- 
ever, of  this  form  is  the  fact  that  it  is  not  always 
permanent  in  its  results,  and  that  the  disintegrated 
elements  tend  to  reunite  into  groups  and  systems  and 
re-emerge. 

The  usual  way  is  to  have  the  systems  disintegrated, 

submerged     into    subconsciousness,    and    then    have 

203 


204  Psychopathological  Researches 

them  frittered  away  by  various  means  largely  depen- 
dent on  the  nature  and  individuality  of  the  case  in 
hand.  In  such  cases  possibly  the  method  that  sug- 
gests itself  is  that  of  substitution.  Of  special  import- 
ance is  the  method  of  emotional  substitution,  and  we 
shall  see  farther  on  what  use  was  made  of  this  method 
in  this  special  case  under  investigation,  a  method  that 
can  be  utilized  in  other  cases  of  similar  character,  of 
which  this  particular  case  may  be  regarded  as  one  of 
a  type.  What  is  specially  important  to  point  out  in 
this  case,  and  which  at  the  same  time  is  true  of  any 
other  cases  of  like  character,  is  the  fact  that  the  work 
of  changing  the  delusional  system  had  to  be  a  slow 
one,  the  central  delusion  persisting  in  spite  of  all 
insistent  suggestions. 

Without  directly  touching  the  nucleus  of  the  delu- 
sional system,  some  unimportant  sensory  changes  were 
first  attempted, —  changes  which  could  not  possibly 
meet  with  any  resistance.  The  lumps  felt  to  the  pa- 
tient alternately  hot  and  cold.  This  was  to  him  a 
source  of  much  annoyance.  An  attempt  was  made  to 
have  these  delusional  sensory  experiences  modified 
and  if  possible  got  rid  of.  This  was  but  partially 
effected,  and  with  great  difficulty.  The  thermic 
changes  of  the  lumps  were  no  longer  so  trouble- 
some ;  this  evidently  brought  some  relief  in  the  gen- 
eral condition  of  the  patient ;  the  affective  tone 
seemed  to  have  become  somewhat  raised  though  to 
a  very  slight  degree.     On  the  whole,  the  method  of 


Subconscious  Disintegration  205 

substitution  of  sensory  elements  in  the  structure  of 
the  delusion,  thus  aiming  to  bring  about  a  transfor- 
mation of  the  delusional  system  and  finally  its  dis- 
organization, signally  failed. 

Realizing  that  any  attempt  at  modification  in  the 
delusional  system,  even  by  such  an  indirect  method 
as  that  of  sensory  substitution,  would  be  unsuccessful, 
the  course  of  disorganizing  the  apparently  unassail- 
able systems  had  then  to  be  taken  up  on  altogether 
different  lines.  The  delusion  had  for  the  present  to 
be  left  alone.  The  direct  modification  of  the  delusion 
was  impossible,  whether  by  substitution  or  by  any 
other  direct  method  ;  in  fact,  it  was  only  conducive  to 
the  strengthening  of  the  central  delusion.  Whatever 
suggestion  was  given,  whatever  combination  of  stimuli 
was  brought  to  act  on  the  delusion,  resulted  in  the  in- 
crease of  material  and  in  further  growth  and  develop- 
ment of  this  highly  systematized  and  systematizing 
delusion.  The  very  nature  of  the  case  did  not  allow 
of  any  direct  action, 

The  course  taken,  however,  to  bring  about  a  dis- 
integration was  suggested  by  the  character  of  the 
mental  trouble  and  by  the  traits  of  the  case  under  in- 
vestigation. The  vigor  and  growth  of  the  delusion 
were  to  a  great  extent  aided  by  the  predominant 
melancholic  affective  conditions  characteristic  of  the 
waking  state.  The  delusion  was  in  fact  cemented 
and  fortified  by  the  melancholic  emotional  states.  A 
change  of  these  states,  it  was  thought  might  in  some 


206  Psychopathological  Researches 

way  or  other  without  changing  the  content  of  the 
delusion,  affect  this  central  organized  system,  this 
mental  cancer,  so  to  say. 

The  changes  of  the  affective  states  were  not  ex- 
pected to  modify  directly  the  delusion,  but  being 
steeped,  so  to  say,  in  a  different  affective  mood  the 
rigidity  of  the  system  might  give  way,  it  might  lose 
its  coherence,  and  thus  make  the  process  of  dissolu- 
tion practicable  and  possibly  easy.  All  efforts  then 
were  naturally  directed  towards  one  purpose,  toward 
the  changing  of  the  affective  states  forming  the 
medium  of  the  delusion.  It  was  attempted  to  carry 
over  the  pleasant  affective  states  and  feeling  of  well- 
being  present  in  the  subconscious  trance  personality 
into  the  melancholic  waking  state,  and  thus  displace 
the  affective  states  of  mental  depression  and  substi- 
tute states  of  pleasure  and  well-being.  In  other 
words,  the  main  purpose  was  to  mingle  and  synthetize 
the  dissociated  emotional  personalities,  the  melan- 
cholic, the  gay,  and  the  grave.  Since  the  first  and 
the  second  subconscious  personalities,  the  gay  and 
the  grave,  became  mingled  and  synthetized  in  the 
course  of  their  own  growth  and  development,  the  gay 
emotional  personality  lapsing  into  the  grave  and 
forming  a  stable  synthesis,  the  dissociated  states  were 
reduced  to  two.  What  had  to  be  accomplished  was 
the  union  or  synthesis  of  these  two  contrasting  emo- 
tional personalities.     . 

This  fusion  of  the  two  emotional  personalities  was 


Subconscious  Disintegration  207 

effected  gradually  and  not  without  difficulty.  At  the 
later  stages  of  this  process  of  fusion,  the  work  of  dis- 
integration of  the  central  delusion  also  began.  To  go 
at  it  in  a  cautious  methodical  way,  the  work  was 
started  from  the  subconscious  regions.  For  this  pur- 
pose, dream  states  were  employed.  During  hypnosis 
dreams  were  suggested  to  the  patient  with  the  object 
of  effecting  changes  in  the  body  of  the  central  delu- 
sion. Although  at  first  the  results  were  rather 
meagre  and  by  no  means  fully  satisfactory,  still  the 
central  system  was  on  the  way  to  dissolution.  Thus 
in  one  of  the  dreams  the  patient's  father  was  to  come 
to  him  and  tell  him  that  he  will  soon  get  rid  of  the 
lumps  and  spots  and  become  fully  well.  These 
dreams  worked  on  the  patient  slowly  and  left  their 
effects  deep  down  in  his  subconsciousness.  Thus  in 
one  of  his  hypnotic  states  the  patient  volunteered  the 
remark  that  his  father  had  told  him  the  truth,  and  that 
his  toes  were  really  getting  drier,  but  that  they  were 
not  yet  completely  dry. 

This  method  of  working  at  the  dissolution  of  the 
delusion  by  dream  states  was  all  the  more  important, 
because  they  really  formed  an  indispensable  substitute 
for  the  depressive,  frightful  dreams  which  aggravated 
the  patient's  melancholic  condition  and  increased  the 
stability  of  the  delusion.  Occasionally  the  bad  dreams 
took  the  upper  hand  in  his  sleep,  but  soon  they  ceased 
to  work  and  gave  way  to  the  good  dreams. 

When   the   two   emotional   personalities   began  to 


208  Psychopathological  Researches 

intermingle  and  the  good  dreams  became  well  estab- 
lished, then  some  effect  could  be  expected  to  result 
from  assaults  on  the  delusional  vein,  soul,  and  spleen. 
Finally  the  delusional  soul  and  spleen  were  dissolved, 
— they  dropped  out  of  the  delusion.  The  patient  be- 
gan to  feel  very  happy.  An  electric  current  was  sub- 
stituted for  the  active  soul,  and  the  patient  felt  the 
change  as  highly  beneficial.  After  emerging  from 
one  of  the  hypnotic  states,  he  began  to  laugh  and 
smile  and  told  us  he  had  had  a  good  dream.  "  This 
is  the  first  time  I  slept  well ;  my  spots  are  removed ; 
since  my  last  year's  trouble  this  is  my  best  sleep." 


CHAPTER  VIII 

DYNAMOGENESIS    AND    DISINTEGRATION    OF    THE 
DOMINANT    SYSTEM 

Seeing  that  the  delusion  was  giving  way,  that  the 
soul  and  the  spleen  were  out  of  the  way,  the  nucleus 
of  the  delusion  was  then  attacked.  Instead  of  lumps, 
small  spots  were  substituted,  as  the  total  annihilation 
of  the  former  could  not  possibly  be  effected, — it  would 
have  met  with  too  much  opposition.  The  line  of  least 
resistance  was  to  follow  the  delusion  and  now  and  then 
to  effect  modifications  and  substitutions.  Immediately 
after  emerging  from  his  hypnotic  state,  the  patient  felt 
so  well  that  he  asked  to  be  rehypnotized.  The  spots 
persisted,  but  they  were  now  associated  with  pleasant 
affective  states  and  happy  moods.  Upon  awaking, 
the  patient  was  happy  and  laughing,  and  declared  that 
the  "  spots  "  (no  longer  "  lumps  ")  ran  off  very  quickly, 
which  gave  him  the  highest  satisfaction  possible.  "  I 
do  not  feel  mixed  up,"  he  said  ;  "  I  like  such  treatment, 
for  I  sleep  well ;  my  toes  are  going  to  be  dry  ;  the 
spots  do  not  stay  thick,  but  thin  ;  I  am  soon  going  to 
be  well  and  happy.  I  wish  the  spots  would  move  at 
night  as  they  do  now  ;  I  feel  light  in  my  feet ;  I  feel 
bright  and  strong." 

J4  209 


210         Psychopathological  Researches 

In  order  to  be  more  sure  of  the  working  of  these 
subconscious  dream  agencies  and  also  to  get  rid  more 
effectually  of  the  old  memories,  amnesia  was  specially 
enforced.  To  weaken  the  intensity  of  the  melan- 
cholic delusional  states  they  were  projected  into  the 
far  past  of  the  patient's  life.  The  patient  was  to  feel 
them  as  past,  as  faint,  as  long  gone  by,  as  difficult  to 
recall.  In  other  words,  the  disintegrated  elements 
as  well  as  the  disintegrating  forces  were  merged  into 
the  subconscious,  there  to  work  out  their  effects  with- 
out the  patient's  knowledge. 

This  enforcement  of  amnesia  is  all  the  more  impor- 
tant, because  of  the  very  effectiveness  of  the  disinte- 
grating forces  :  When  a  system  present  in  the  upper 
personal  consciousness  is  to  be  disintegrated,  the  sugges- 
tions given  should  be  kept  out  of  the  patient's  personal 
memory.  One  can  observe  this  fact  clearly  in  post- 
hypnotic suggestions.  If  a  post-hypnotic  suggestion 
is  fully  remembered,  it  usually  miscarries, —  the  sug- 
gestion loses  its  efficacy,  and  most  often  comes  up 
as  a  word-memory  without  the  stringency  of  realiza- 
tion, motor  or  sensory.  When,  however,  amnesia  is 
enforced,  the  post-hypnotic  suggestion  is  fully  real- 
ized. A  dissociated  system  present  in  the  subconscious 
when  coming  to  the  surface  of  the  upper  strata  of  con- 
sciousness becomes  manifested  with  intense  sensori- 
motor energy.  Dissociation  gives  rise  to  greater 
dynamogenesis.  This  principle  of  dynamogenesis  is 
very  important,  and  cases  of  so-called  impulsive  in- 


Dynamogenesis  and  Disintegration      211 

sanities  and  psychic  epilepsy  are  really  due  to  this  cause 
and  are  worked  on  this  principle  with  great  success. 

A  system  entering  into  the  association  with  other 
systems  is  set  into  activity  not  only  directly  by  its  own 
appropriate  stimuli,  but  also  indirectly  through  the 
activities  of  the  various  systems  associated  with  it. 
These  associative  interrelations  bring  about  an 
equable  and  normal  functioning  activity,  controlled 
and  regulated  by  the  whole  mass  of  associated  sys- 
tems. The  mass  of  associated  systems  forms  the  "re- 
ductives  "  of  each  individual  system.  In  dissociated 
systems  the  controlling  influence  of  the  "  reductive 
mass"  is  lost  and  the  result  is  an  over-activity  un- 
checked by  any  counteracting  tendencies. 

This  relation  of  dissociation  and  dynamogenesis  is 
closely  related  to  periodicity  of  function  with  its  con- 
comitant manifestation  of  psychomotor  activity  char- 
acteristic of  all  passions  and  periodically  appearing 
instincts.  Dissociated  systems  present  impulsiveness, 
because  of  lack  of  associated  counteracting  systems. 
The  only  way  to  diminish  the  overpowering  im- 
pulsiveness with  which  the  dissociated  subconscious 
systems  make  an  onset  in  their  rush  into  the  upper 
region  of  personal  consciousness  is  to  bring  about  an 
association,  to  work  the  dissociated  system  into  the 
tissue  of  the  patient's  consciousness.  As  we  shall 
discuss  this  principle  of  dynamogenesis  in  its  proper 
place,  we  make  here  only  a  reference  to  the  subject. 

Physiologically,    it    may   be    said    that    a  neuron- 


212  Psychopathological  Researches 

aggregate,  entering  into  association  with  other  aggre- 
gates and  being  called  into  activity  from  as  many 
different  directions  as  there  are  aggregates  in  the 
associated  cluster,  has  its  neuron  energy  kept  within 
the  limits  of  the  physiological  level.1  A  dissociated 
neuron-aggregate,  on  the  contrary,  is  not  affected  by 
the  activity  of  other  aggregates ;  it  is  rarely  called 
upon  to  function  and  stores  up  a  great  amount  of 
neuron  energy.  When  now  an  appropriate  stimulus 
liberates  the  accumulated  energy,  the  activity  is  over- 
whelming and  is  very  much  like  the  eruption  of  an 
underground  volcano,  giving  rise  to  temporary  attacks, 
to  "  seizures  "  by  subconscious  states  of  the  whole 
field  of  the  upper  consciousness, — "seizures"  which 
being  really  of  the  nature  of  post-hypnotic  automatisms 
are  generally  mistaken  for  epilepsy,  the  attacks  being 
regarded  as  epileptic  manifestations,  as  "  larval  ep- 
ilepsy," as  "  epileptic  equivalents,"  as  "  psychic  ep- 
ilepsy."2 With  the  restoration  of  equilibrium  of  the 
neuron-aggregates,  with  the  synthesis  of  the  dis- 
sociated systems,  a  synthesis  which  can  be  brought 
about  by  different  methods,  the  subconscious  erup- 
tions, attacks,  or  "  seizures  "  vanish  never  to  return. 
This  principle  of  synthesis  of  dissociated  systems  is 
clearly  demonstrated  in  our  researches,  some  of  which 
appear  in  the  present  series  and  will  be  fully  de- 
veloped in  subsequent  series. 

1  "  Neuron  Energy,"  Archives  of  Neurology  and  Psychopathology,  vol.  i.,  p.  I. 

2  "  Epilepsy  and  Expert  Testimony."  State  Hospitals'  Bulletin,  vol.  ii.,  p.  189. 


Dynamogenesis  and  Disintegration      213 

In  cases  where  a  stably  organized  system  is  to  be 
disintegrated  by  the  artificial  formation  of  counter- 
acting systems,  the  principle  of  dynamogenesis  by  dis- 
sociation is  of  the  highest  consequence. 

What  was  necessary  to  do  in  the  case  under  inves- 
tigation was  to  follow  the  lines  of  this  dynamogenetic 
principle  and  enforce  amnesia  for  the  disintegrating 
agencies,  in  order  to  give  them  the  energy  of  bearing 
down  with  full  force  on  the  central  delusional  system 
and  shattering  it  into  fragments,  which  in  their  turn 
were  to  be  further  dissolved  in  the  subconscious 
and  absorbed  and  assimilated  by  various  systems  to 
which  they  could  offer  but  little  resistance.  At  the 
same  time  pleasant  dreams  were  inserted  with  full 
memory  of  them  on  awaking.  The  object  of  these 
dreams  was  to  raise  the  pleasantness  of  the  affective 
moods  in  waking  states.  Thus  dreams  were  inserted 
in  which  the  patient  was  to  see  one  of  the  experimen- 
ters who  was  to  assure  him  that  the  spots  would  soon 
disappear  and  that  he  would  get  well.  In  this  way  the 
forces  that  were  at  work  day  and  night  in  undermin- 
ing the  delusional  system  could  not  possibly  be  coun- 
teracted by  the  patient's  consciousness  and  were  fully 
effective  in  their  results. 

More  often  the  dream  states  were  absent  from  the 
patient's  upper  consciousness  only  in  so  far  as  con- 
tent was  concerned ;  what  was  remembered  was 
their  affective  tone, — nearly  all  of  them  were  pleasant. 
The  patient  used  to  tell  that  he  had  pleasant  dreams, 


214  Psychopathological  Researches 

but  that  he  had  forgotten  them.  No  effort  was 
made  to  bring  them  out  as  it  was  rather  preferred  to 
have  them  remain  in  the  subconscious.  Sometimes 
what  remained  reverberating  in  the  patient's  mind 
after  he  had  emerged  from  his  normal  sleep  in  the 
morning  was  just  a  phrase,  "  You  are  well  and  dry," 
evidently  the  remnant  of  some  forgotten  dream. 
The  mode  of  breaking  up  the  established  system 
by  means  of  dreams  lapsing  from  conscious  memory 
proved  very  successful ;  the  patient  used  to  wake  in 
a  happy  mood  feeling  that  his  melancholic  state  was 
almost  totally  gone. 

One  of  the  important  modes  employed  in  breaking 
up  and  dissolving  the  delusion  was  that  of  limitation 
of  the  delusional  nucleus.  The  spots,  instead  of  being 
left  in  the  dispersed  condition  as  conceived  by  the 
patient,  were  by  a  persistent  effort  more  and  more 
confined  and  limited  to  definite  areas.  By  different 
modes,  sensory  and  motor,  the  spots  were  finally  con- 
fined to  the  legs  and  arms,  while  at  the  same  time 
the  lumps  were  reduced  to  small  spots,  which  the 
patient  insisted  on  feeling  as  "  wet " ;  hence  they 
went  under  the, name  of  "small  wet  spots,"  of  which 
the  patient  made  a  diagram.  The  hole  through 
which  the  lumps  used  to  make  their  escape  was  of 
course  preserved  in  order  to  have  a  well  established 
place  of  exit  for  the  small  wet  spots.  Further  limita- 
tion brought  the  spots  down  to  the  legs,  and  there 
they  finally  became  confined  to  a  single  foot,  and  then 


Dynamogenesis  and  Disintegration      215 

most  of  them  became  localized  in  the  toes.  This 
limitation  and  localization  of  the  spots  on  a  small 
circumscribed  area,  so  as  to  diminish  the  importance 
of  the  spots  by  the  reduction  of  their  massiveness  and 
extension,  met  at  first  with  much  resistance.  Only 
after  persistent  repetition  did  the  attempt  at  limita- 
tion finally  succeed. 

The  sensation  of  wetness,  which  the  patient  at- 
tributed to  the  toes,  was  found  to  be  very  per- 
sistent. An  attempt  was  therefore  made  to  have 
this  sensation  assimilated  to,  or  rather  substituted 
by,  a  normal  sensation, —  that  of  sweat.  It  was 
expected  that  once  this  was  effected  the  illusory  or 
rather  delusive  perception  of  wetness  could  be  re- 
moved in  some  very  simple  way,  such  as  by  thermic 
or  electric  stimulations.  It  turned  out,  however,  that 
this  wetness  could  not  be  removed,  and  although  it 
could  be  assimilated  to,  or  substituted  by,  the  sensa- 
tion of  sweat,  still  that  suggested  delusional  sweat  of 
the  spots  could  not  be  fused  with  the  ordinary  normal 
sensation  of  sweat  of  the  toes.  The  patient  persist- 
ently distinguished  two  kinds  of  sweat  sensations  : 
that  of  the  spots,  which  he  termed  "  inside  "  sweat ; 
and  the  normal,  which  he  termed  "  outside  "  sweat. 
Suggestions  given  to  the  effect  that  the  spots  should 
be  felt  on  the  toes  were  not  taken  by  the  patient, — 
he  felt  the  wet  spots  in  the  toes.  It  is  very  probable 
that  the  sensation  of  the  spots  was  given  rise  to  by 
some  form  of  paresthesia.     The  whole  course  of  the 


216  Psychopathological  Researches 

process  of  dissolution  was  towards  further  disintegra- 
tion of  the  now  degenerated  nucleus  of  the  delusion, 
namely,  the  wet  spots.  The  spots  became  limited  to 
a  small  area,  and  the  sensation  of  wetness  was  counter- 
acted by  a  suggested  sensation  of  dryness. 

One  thing  that  specially  deserves  our  attention  is 
the  fact  that  the  delusion  formed  such  a  stably  organ- 
ized system  that  the  only  way  of  getting  at  it  was  to 
follow  in  its  wake  and  attack  it  in  the  rear,  so  to  say, 
but  never  face  it.  The  patient  was  led  by  apparently 
closely  following  him.  The  complete  destruction  of 
the  delusion  and  the  full  restoration  of  the  healthy 
normal  state  had  to  be  put  in  such  a  way  as  to  make 
the  patient  feel  that  they  came  all  of  his  own  initiative, 
of  his  own  free  will,  so  to  say.  The  diseased  mental 
state  is  to  disappear,  and  the  healthy  condition  is  to 
come  spontaneously.  Hence,  it  is  highly  character- 
istic to  find  that  the  patient  often  makes  his  own 
diagnosis  as  well  as  prognosis,  and  foretells  changes  in 
his  own  mental  condition.  This  method  of  having 
the  changes  wrought  in  the  patient's  mind  appear  to 
emanate  from  his  active  sense  of  personality  was  de- 
manded by  the  very  nature  of  the  case.  This  method 
was  found  highly  satisfactory  in  other  cases  unlike 
this  in  character.  The  modifications  effected  by  this 
method  in  the  mental  condition  of  the  patient  are 
permanent ;  they  become  part  and  parcel  of.  his  living 
personality.  Meanwhile,  the  process  of  disintegration 
of  the  organized  delusion  went  on  slowly  but  surely. 


CHAPTER  IX 

RE-EMERGENCE    OF    DISINTEGRATED    GROUPS   AND    THEIR 
FINAL    DISSOLUTION 

The  broken -off  chips  and  fragments  from  the 
main  systems  were  not  soon  dissolved,  but  persisted 
for  some  time  in  the  subconscious  and  now  and 
then  emerged  into  the  patient's  upper  consciousness. 
More  often  they  appeared  in  the  hypnotic  states,  and 
also  in  the  dream  states,  and  at  frequent  intervals 
they  reappeared  in  the  fully  waking  states.  The 
patient  often  complained  that  in  his  sleep  the  mem- 
ories of  his  bad  feelings  came  back  and  made  him 
feel  worse  on  awaking-.  In  another  of  his  dream 
states,  a  physician  resembling  Dr.  N.,  about  whom 
amnesia  had  been  enforced,  reappeared  and  gave 
directions  bringing  about  a  reinstatement  of  disin- 
tegrated mental  systems.  Fragments  broken  off  some 
months  ago  and  seemingly  destroyed  have  been  com- 
ing up,  showing  that  it  takes  time  before  the  com- 
plete dissolution  of  the  constituents  of  an  organized 
system  actually  occurs.  In  one  of  his  hypnotic  states, 
the  patient  suddenly  referred  to  sensory  troubles  in 
the  rectum,  troubles  that  could  be  traced  to  a  ques- 
tion put  to  the  patient  some  ten  months  before. 


2i8  Psychopathological  Researches 

The  unexpected  emergence  of  fragments  of  disin- 
tegrated and  subconsciously  buried  mental  systems  is 
not  infrequent  in  the  domains  of  the  subconscious. 
A  group  which  is  almost  completely  forgotten  and  is 
regarded  as  dead,  and  has  seemingly  entirely  van- 
ished from  life  activity,  suddenly  revives  and  comes 
to  light  again  from  the  depths  of  subconscious  re- 
gions. The  mode  of  manifestation  of  these  isolated 
broken-off  chips  of  formerly  extensive  mental  systems 
is  very  much  of  the  same  nature  as  found  in  the 
phenomena  of  fixed  ideas,  impulsive  insanities,  and 
psychic  epilepsies.  An  isolated  mental  system  sud- 
denly emerges  without  apparent  relation  to  the 
patient's  mental  life  and  brings  about  psychomotor 
disturbances  often  of  considerable  extent  and  of 
serious  character.  Many  forms  of  attacks  with  char- 
acteristic auras  of  seemingly  epileptic  character 
can  be  traced  to  recurrent  upheavals  of  such  sub- 
consciously buried  fragmentary  mental  groups  and 
systems. 

When  such  systems  do  come  up,  and  it  is  of  vital 
importance  to  bring  up  as  many  of  them  as  possible 
so  as  to  get  rid  of  psychomotor  disturbances  and 
"attacks,"  the  only  way  is  to  bring  them  into  the 
clear  light  of  consciousness  and  have  them  associated 
with  antagonizing  mental  systems,  thus  re-establish- 
ing psychomotor  equilibrium.  The  course  of  the 
process  of  dissolution  of  the  depressed  delusional 
mental  states  in  this  case  of  typical  functional  melan- 


Final  Dissolution  219 

cholia  was  from  subconscious  disintegration  to  con- 
scious redintegration. 

The  physician,  the  psychiatrist,  who  has  also  the 
practical  aspect  in  view,  will  no  doubt  be  interested 
to  know  that  the  patient  is  now  in  good  condition, — 
his  melancholic  delusional  state  has  completely  dis- 
appeared and  he  has  resumed  his  former  vocation. 


Mental    Dissociation    in    Depressive 
Delusional   States. 

EXPERIMENTAL  DATA. 

By 

Boris  Sidis  and  George  M.  Parker 

The  following  experimental  notes  are  selected  from 
a  mass  of  material  collected  during  studies  of  the  case 
in  the  laboratory.  They  are  given  in  the  form  in 
which  they  were  taken,  with  many  details  omitted, 
but  without  any  attempt  to  make  them  more  connected 
and  readable.  The  interesting  feature  of  these  notes 
is  that  they  show  the  condition  of  the  patient  at  vari- 
ous periods  in  the  progress  of  his  disease.  The  un- 
modified character  of  these  notes  puts  the  reader  in 
closer  touch  with  the  actual  manifestations  as  they 
were  directly  observed  in  the  laboratory,  manifesta- 
tions on  which  the  preceding  paper  is  based  : 

J.  F.,  aged  twenty-six,  clerk.  Family  history  is 
negative;  there  are*  six  children  in 'the  family,  the 
patient  is  the  third.  He  had  been  temperate,  and 
denied  syphilis ;  never  had  rheumatism,  or  scarlet 
fever,  or  diphtheria,  typhoid  ;  had  been  working  very 
hard  up  to  the  time  of  his  illness.  There  were  no 
special  causes  of  worry,  no  excesses. 


Experimental  Data  22 1 

In  February,  1900,  the  patient  began  to  lose  appe- 
tite, to  have  headaches,  there  was  loss  of  attention, 
memory  became  unreliable,  there  was  a  desire  to 
seclude  himself,  great  emotional  depression,  bowels 
became  costive,  and  bodily  condition  generally  poor 
There  was  a  probable  history  of  malaria  persisting 
for  some  time  previous  to  the  disease,  but  this  could 
not  be  well  verified. 

At  his  first  attack,  there  was  considerable  nausea, 
abdominal  pain,  depression  passing  into  intense  anx- 
iety, etc.  He  was  seen  by  the  local  doctor,  who  told 
him  that  he  had  "lumps."  The  suggestion  of  lumps 
formed  a  nucleus  of  a  highly  systematized  delusion. 
The  patient  actually  felt  them  for  the  first  time,  and 
described  them  as  being  beneath  the  mucous  mem- 
brane of  his  stomach.  Since  this  time  the  delusion 
of  the  lumps  has  persisted  and  developed.  The 
lumps  spread  to  other  parts  of  the  body,  to  the  arms, 
to  the  legs,  with  sudden  changes  of  location.  He 
believed  he  had  worms  that  ate  the  lumps,  and  the 
soul  and  specially  the  spleen  were  the  chief  scav- 
engers. The  soul  and  the  spleen  communicated  by 
signals. 

Five  days  before  he  became  sick,  the  soul  began 
working,  rubbing  the  lumps  out  and  getting  them 
out  of  the  way.  At  that  time  the  lumps  went  in  the 
same  hole  at  which  they  now  enter.  The  spleen 
would  grunt  when  the  soul  worked  right,  but  not  like 
a  "  man's  grunt."     The  worms  meantime  were  working 


222  Psychopathological  Researches 

against  the  soul.  He  could  feel  the  soul  come  out 
and  open  the  mucous  membrane  and  clean  out  the 
worms.  The  worms  were  very  angry.  Then  they 
became  still ;  they  had  been  eating  the  lumps,  but 
did  not  like  them  ;  the  lumps  apparently  anteceded 
the  worms ;  the  lumps  and  worms  did  not  agree. 
The  soul  also  cleaned  all  the  lumps  out  of  the  head 
into  the  veins,  and  the  veins  brought  them  to  the  stom- 
ach ;  when  the  patient  became  inattentive,  however, 
and  too  weak  to  notice  these  lumps,  the  soul  did 
not  work  so  well.  The  spleen  told  the  soul  at  this 
time,  by  signs,  to  stop  ;  the  soul  never  answered,  but 
understood. 

At  this  time  he  went  to  the  hot  baths.  Here  the 
veins  began  to  "draw,"  and  then  the  spleen  began  to 
work  in  order  to  get  out  the  lumps.  His  bowels 
were  especially  costive  at  this  time,  there  was  con- 
siderable abdominal  pain,  and  he  was  sleepless.  He 
said,  "  I  looked  out  of  my  eyes  and  I  could  not  see." 
The  lumps  in  the  body  began  to  feel  alternately  hot 
and  cold  about  September,  1900. 

Since  this  time,  the  localization  of  the  lumps  has 
become  more  definite.  The  heat  and  the  cold  are 
less  shifting  ;  his  veins  continue  to  "draw."  Patient 
has  no  definite  idea  as  to  causation.  No  external  or 
objective  references.  No  history  of  anything  further 
than  noted.  Especially  has  there  been  no  intestinal 
disease. 

November  30,    1900:  Patient  examined  as  to  his 


Experimental  Data  223 

sensations,  no  changes  were  evident.  There  was  no 
hypnosis  at  this  time. 

December  5,  1900  :  Hypnotized  ;  patient  becomes 
completely  changed ;  melancholia  is  gone ;  he  is 
jovial,  merry,  and  keeps  on  laughing  and  roaring 
without  any  provocation.  Says,  "  I  feel  well."  Delu- 
sion of  lumps  persists.  Suggestion  made  as  to  heat 
and  cold  ;  as  to  anaesthesia,  entirely  successful.  Dur- 
ing pricking  of  the  hand  some  exhibition  of  subcon- 
scious phenomena  as  evidenced  by  shaking  and 
shivering,  but  the  patient  makes  no  reference  to  this 
sensation.  Later,  suggestion  as  to  diffuse  warmth, 
which  was  successful.  Post-hypnotic  suggestion  as 
to  localization  of  the  spots,  of  the  heat  and  cold  to  be 
limited  to  one  area,  the  right  forearm  and  hand. 
Condition  apparently  improved  after  hypnosis. 

December  7,  1900  :  He  states  that  his  right  hand 
is  cold,  that  his  left  and  the  rest  of  his  body,  except  the 
right  foot  are  warm  ;  no  amnesia  as  to  the  suggestion. 
He  dreams  of  frightful  characters,  never  about  being 
hurt  or  damaged.  During  early  part  of  his  sickness, 
dreamed  that  his  spleen  was  jumping  around  and 
removing  the  lumps.  Denies  ever  having  read  of 
this.  One  night  he  cried  out  that  he  was  afraid  his 
spleen  would  jump  out  through  his  chest.  No 
somnambulism.  One  time,  after  rubbing  turpentine 
over  the  body,  with  some  consequent  pain,  shortly 
after  he  felt  the  same  pain  over  diffuse  and  separate 
areas   of  his  body,  as  if  some   one   had  thrown  the 


224         Psyche-pathological  Researches 

turpentine  upon  him.  During  this  period,  in  reading 
he  could  not  follow  the  type,  he  became  mixed  up 
and  would  not  know  what  he  was  reading  about.  If 
he  attempted  to  carry  it  on  he  would  have  an  in- 
crease of  pain  until  he  had  to  cease.  At  times  very 
melancholic. 

Thermic  tests  showed  that  his  sensations  as  to 
heat  and  cold,  were  normal  at  this  time.  No  kin- 
aesthetic  abnormalities.  It  was  suggested  that  there 
would  be  absence  of  pain,  absence  of  heat  and  cold 
except  in  the  middle  finger  of  the  right  hand. 

December  n,  1900:  Condition  much  improved; 
the  heat  and  cold  sensations  have  not  limited  them- 
selves to  the  area  circumscribed  as  in  last  suggestion, 
but  are  noticeable,  especially  in  the  legs  and  lower 
part  of  the  body.  With  this  increase  in  somatic  sensa- 
tion the  synthesis  is  apparently  increased.  He  can  read 
and  not  forget ;  he  walks  without  being  frightened ; 
sleeps  better,  and  has  had  no  further  dreams,  until 
last  night  when  he  felt  the  spleen  pull  for  the  first  time. 
He  always  remembers  his  troubles  better  when  he  is 
feeling  well.  He  felt  distinctively  better  after  leaving 
here  ;  very  happy  and  joyful.  He  is  constantly  re- 
counting his  delusions  and  likes  to  dilate  on  them. 
Suggested  constant  insistence  upon  the  disappear- 
ance of  the  spots.  Of  not  remembering  the  chill  or 
the  cold  experienced  in  his  first  hypnosis,  but  rather 
of  constantly  feeling  warm. 

December  I2th-i4th:  Pain  again  in  his  leg.     He 


Experimental  Data  225 

calls  it  a  "separation  of  the  mucous  membrane."  He 
can  read  more  intelligently  and  remembers  more. 
Under  hypnosis,  it  was  suggested  that  the  pain  dis- 
appear.    He  seems  to  be  hypnotized  more  readily. 

The  second  hypnosis  far  deeper.  Change  very 
great.  Looks  quiet  and  grave  though  contented. 
Contrast  to  the  melancholic  waking  state  and  merry 
hypnotic  state  is  very  striking.  Remembers  well. 
No  memory  on  awaking.  Attempt  towards  raising 
general  affective  tone.  Instead  of  directing  the  meas- 
ures toward  changing  of  sensation  it  is  rather  an  attack 
on  the  affective  state. 

December  i5th-2ist:  Feeling  happier,  memory  is 
better,  reads  more  and  more  rapidly ;  he  sleeps  bet- 
ter, and  has  no  dreams.  Feels  pain  in  right  leg  only, 
then  it  is  rather  a  feeling  of  "grain  over  the  skin." 
He  brought  a  sample  of  grain  to  show  this.  He 
limped  from  the  pain  in  his  leg  ;  this  limp  was  re- 
moved by  suggestion.  The  subconscious  phenomena 
of  heat  and  cold,  which  appeared  during  the  first 
hypnosis,  are  still  present.  Suggestion  is  still  directed 
toward  affective  states.     Constantly  improving. 

December  22d-2C)th  :  He  looks  brighter,  is  more 
attentive,  reads  continuously  with  a  distinct  memory 
of  what  he  has  read.  Does  not  think  as  much  as 
usual  about  himself.  Pain  only  in  the  right  foot 
with  a  feeling  of  heat  and  cold,  as  per  suggestion. 
Nowhere  else  is  this  found.  Electricity  was  begun 
at  this  time. 


226  Psychopathological  Researches 

He  feels  happy  in  the  evening ;  the  change  is  im- 
mediate after  hypnosis  ;  is  no  more  afraid  ;  he  has 
seen  the  effect  of  the  lumps  in  the  black  underneath 
the  nails  ;  as  he  feels  them  drop  off,  he  smiles.  In  all 
attempts  at  diffusion  of  the  feeling,  there  is  an  insist- 
ence upon  a  warm  feeling  in  the  region  of  the 
epigastrium.  All  attempts  at  amnesia  of  the  sug- 
gestions given  when  patient  is  in  the  "gay"  state 
are  unsuccessful.  Feels  that  he  will  be  well  within 
two  weeks. 

January  2,  1901  :  Suggested  that  he  should,  after 
waking  up,  hand  a  "  lump  "  to  S.  Amnesia  enforced  ; 
at  first  he  could  not  remember  ;  gradually  the  memory 
came  back  when  asked  if  P.  had  not  told  him  some- 
thing, and  then  the  specific  recollections  emerged. 
The  second  time  hypnotized,  the  same  orders  en- 
forced, and  post-hypnotic  suggestions  made  more 
specific.  Patient  woke  up  but  did  not  remember  ; 
still  the  suggestion  developed  partially.  Hypnotized 
again,  with  post-hypnotic  suggestion  still  more  strenu- 
ously enforced  ;  still  not  successful.  Put  into  hyp- 
nosis ;  when  partially  awakened,  patient  looked  out 
of  the  window,  thought  he  was  in  his  own  home, 
looked  about  with  amazement,  but  recognized  no 
one ;  thought  some  one  had  been  speaking  to  him  in 
his  own  home.  Said  nothing  for  a  moment,  and  soon 
completely  awakened  and  recognized  those  about  him  ; 
he  remembered  about  his  shoe  being  off.  Post-hyp- 
notic suggestion  was  not  efficient.     He  goes  back  into 


Experimental  Data  227 

the  state  of  hypnosis  readily.  Patient  was  put  into  a 
deeper  hypnosis.  Sudden  marked  emotional  transfor- 
mation ;  from  boisterous,  gay,  and  light-hearted  be- 
came quiet,  sedate,  and  grave.  He  awakens  in  a 
startled  manner  ;  could  not  remember  taking  his  shoes 
off.  Complete  amnesia ;  post-hypnotic  suggestions 
are  not  followed  out. 

After  awaking,  he  says  he  does  not  remember 
having  seen  Dr.  S.,  but  remembers  P.  When  asked 
what  time  he  would  come,  he  could  not  remember,  but 
said  he  remembered  what  P.  said.  Does  not  remem- 
ber that  S.  has  told  him  something. 

January  19th  :  Has  said  that  at  some  time  he  saw 
and  heard  things  without  understanding  them ;  feels 
the  lumps  now  only  between  the  toes  ;  dropping  out 
now  every  day  ;  knows  that  they  will  disappear  at 
this  rate  in  two  weeks ;  extremely  sensitive  over 
extremities  ;  feeling  of  cold  and  warmth  reproduced 
as  in  first  experiments.  Movements  of  his  arms  and 
toes  produced  as  though  bathing.  This  is  in  hypno- 
sis and  afterwards. 

January  21st:  He  feels  better,  the  lumps  are 
getting  better ;  he  knows  they  are  dropping  out ; 
cannot  catch  them  because  they  run  away ;  idea 
of  lumps  is  very  indefinite  ;  lumps  also  run  up  the 
bowels  and  run  down  the  bowels  and  emerge  with 
the  movements  ;  he  feels  them  in  the  passages  of  the 
bowels. 

The    succession    of  the   two    contrasting  affective 


228         Psychopathological  Researches 

personalities  is  still  very  striking  ;  the  gay  is  of  very 
brief  duration. 

January  26th  :  Feels  worse  ;  notices  the  spots  upon 
the  mucous  membrane  for  the  past  two  days.  His 
attitude  and  expression  are  again  depressed  ;  in  taking 
a  tremor  tracing  of  the  right  hand,  he  felt  the  spots 
run  off  his  left  leg.  The  same  as  to  the  spots  in  his 
head  ;  he  has  a  pain  in  the  right  side  of  his  head 
when  his  left  hand  is  engaged.  On  awaking  from 
hypnosis,  there  is  a  reverse  procession  of  the  affec- 
tive states ;  the  superficial  states,  which  are  now  very 
brief,  being  characterized  by  gaiety,  the  deeper  states 
by  quietness.  Hypnotic  suggestion  that  he  must 
light  a  match  after  awaking ;  on  awaking  and  hear- 
ing the  signal,  he  began  to  laugh  and  stretched  out 
his  hand  for  a  match  ;  asked  "  whose  are  they  "  ;  then 
said,  "  Maybe  I  will  light  one  ";  said  he  would  pay  for 
it,  and  insisted  upon  lighting  it  in  spite  of  our  efforts 
to  the  contrary  ;  said  he  liked  to  smoke,  then  later 
said  he  wished  to  warm  the  room.  After  lighting  the 
match,  he  said  :  "  I  dreamed  about  lighting  a  match, 
that  I  would  have  to  see  fire ;  some  one  wanted  to 
take  away  my  memory."  During  his  hypnosis  he  was 
pricked  in  his  hand  ;  he  remembers  this  also  as  in  his 
dream. 

He  goes  now  rapidly  into  the  deeper  hypnosis  ; 
the  "gay"  stage  is  extremely  brief;  the  emotional 
change  is  very  marked ;  he  is  no  longer  gay  and 
laughing,    but  quiet   and   grave,  still  very   cheerful 


Experimental  Data  229 

and  contented.  After  awaking  from  hypnosis,  he 
looked  in  the  chair,  asking  to  see  "  the  black  cat," 
which  it  had  been  suggested  he  should  see  after 
awaking.  He  took  up  a  weight  which  had  been 
placed  purposely  in  the  chair,  and  said  "  This  is 
not  the  cat."  It  was  suggested  that  it  was  a  dead 
black  cat.  He  looked  around  for  it,  then  said  he 
wanted  to  see  the  cat,  that  he  would  find  the  cat,  that 
he  had  dreamed  about  it,  and  wanted  to  take  it  and 
pet  it.  Then  he  took  up  the  weight  and  laughed, 
and  said  it  has  the  color  of  the  cat,  and  took  it  in  his 
hands,  and  passed  his  hand  over  it.  When  asked 
why  he  rubbed  it,  he  said,  "  There  is  no  question 
about  it."  He  asked  how  much  it  was  worth.  When 
asked  why  he  wanted  it,  he  said  it  was  the  color  of  a 
black  cat,  and  he  wanted  to  buy  it.  He  then  took  it 
and  pushed  it  back  and  forth,  as  in  the  fatigue  ex- 
periments. Again  when  asked  why  he  rubbed  it,  he 
said  that  he  would  go  into  the  next  room  and  rub  it. 

He  said,  "  It  is  the  first  time  I  have  seen  it "  ;  he 
reiterates  this.  When  insistence  is  made  upon  the 
reproduction  of  the  sensory  suggestion,  the  motor 
associations  of  the  fatigue  experiments  only  are  real- 
ized. He  rubs  the  weight  on  his  leg,  then  incorpor- 
ating these  motor  associations  into  his  delusional 
system,  says  that  in  so  rubbing  it  the  spots  come  off. 
Complete  amnesia  after  awaking. 

Before  awaking,  the  weight  had  been  put  in  his 
pocket,  where  he  found  it.    He  asked  who  put  it  there, 


230         Psychopathological  Researches 

and  if  some  one  were  not  in  the  room.  He  thought 
that  the  matches  and  weight  were  in  the  chair  —  that 
they  must  have  been  in  the  chair.  He  does  not  care  for 
either  the  matches  or  the  weight.  Absolute  amnesia 
afterward.  He  thinks  somebody  has  told  him  that 
he  could  have  the  weight.  When  asked  if  he  re- 
membered anything  about  the  hypnosis,  he  remem- 
bered nothing,  not  even  of  any  dream,  but  he  thought 
the  weight  was  good  for  exercising,  and  for  iron- 
ing,—  both  of  which  are  memories  from  the  states 
intervening  between  the  hypnoses. 

January  30,  1 901:  He  feels  the  lumps  still.  Theyare 
still  coming  up  to  his  body.  Hypnosis,  very  readily 
effected,  but  less  of  the  emotional  disturbance  which 
characterized  it  at  first.  Post-hypnotic  suggestion 
that  he  will  see  the  picture  of  P.  Picture  was  repre- 
sented by  a  circular  outline  of  head  and  shoulders. 
Complete  amnesia  on  awaking.  He  looks  at  the 
picture,  and  laughs  and  says  that  it  is  not  right,  but 
that  he  could  identify  it  among  others  ;  he  says  it 
has  no  nose,  nor  eyes,  but  that  it  must  be  his  pic- 
ture, because  "  it  is  on  the  paper  used  here  when  I 
came."  Later,  says  it  is  only  some  marks  ;  that  it  is 
nothing  else,  and  that  the  paper  is  the  only  thing 
which  helps  him.  No  illusory  phenomena ;  sensory 
element  recognized  exactly.  Patient  put  in  deep 
hypnosis  ;  suggestion  that  he  is  to  see  on  paper  a 
man  in  a  suit  about  whom  he  is  to  dream  ;  he  is 
awaked  ;    said   that  the    man  is    not  swell,   that    he 


Experimental  Data  231 

has  no  good  clothes  on,  that  he  is  not  well  dressed ; 
the  man  has  black  clothes  ;  he  sees  the  picture  plainly 
with  a  double-breasted  coat.  The  picture  is  simply  a 
few  lines,  but  he  works  out  all  the  details.  He  evi- 
dently has  blended  the  two  suggestions, — the  general 
about  the  man  and  the  particular  about  P.  Said 
he  had  dreamed  of  an  iron  burning  him  ;  this  was 
due  to  the  weight  with  which  he  played  in  the  hyp- 
notic state  at  a  previous  time,  and  under  previous 
suggestion,  that  he  would  feel  better  with  this  weight. 

P.  hypnotized  patient,  suggested  sensory  hallucina- 
tion of  a  figure  (fly)  ;  when  a  signal  (knock)  was  given, 
suggestion  realized,  saw  the  fly  and  caught  it,  let  it 
go,  then  looked  for  it  everywhere  ;  he  picked  up  P's 
picture,  the  one  suggested  previously,  and  said  it  was 
P's  picture,  and  wanted  to  take  it ;  pointed  out  all 
the  details. 

Hypnosis,  suggestion  to  see  father,  and  speak  to 
him  ;  wakes  up,  took  P.  to  be  his  father,  and  spoke 
English,  although  his  father  speaks  only  Russian. 
When  asked  where  Dr.  P.  was,  said  he  had  him  in 
his  pocket.  When  insisted  that  he  see  P.,  said  that 
he  did  not  care  to  see  him,  that  P.  was  very  busy ; 
re-hypnotized  and  suggested  that  he  see  sister  open 
the  door  and  come  in,  while  it  was  further  suggested 
that  his  father  was  going  to  help  him  in  his  trouble 
and  take  his  spots  away ;  awaked  and  said,  "May 
I  eo  to  the  door?"  He  did  not  see  his  sister  until 
D.   came   in,  and  then   he   took  him  for  his  sister. 


232  Psychopathological  Researches 

Finally,  when  we  attracted  his  attention  to  the  differ- 
ence between  D.  and  his  sister,  said  we  were  mixing 
him  up,  and  finally  told  D.  to  go  away,  that  every- 
body laughs  at  him,  and  said,  "  I  shall  not  take  you 
up  here  any  more."  When  we  insisted  that  he  open 
his  eyes  and  see  D.,  he  still  insisted  that  D.  was  his 
sister,  and  that  he  was  not  out  of  his  mind. 

February  ist :  Still  feels  lumps  ;  said  he  had  a  bad 
dream,  that  two  men  were  trying  to  kill  him,  and  that 
he  had  called  the  firemen  for  help  ;  the  men  in  the 
dream  resembled  no  one ;  he  felt  mixed  up  after 
awaking.  He  remembered  this  in  the  night,  directly 
after  waking  up,  but  not  on  the  next  morning.  Did 
not  dream  about  his  father  or  sister ;  does  not  re- 
member having  his  sister  or  father  here  last  time. 
Remembers  that  the  picture  was  one  of  P.,  but  now  it 
does  not  look  like  him  ;  he  knows  it  is  not  one  of  P., 
he  only  dreamed  of  it.  As  soon  as  he  wakes  up,  he 
knows  that  the  spleen  works  between  his  toes,  where 
during  hypnosis  the  electricity  is  applied.  The  spleen 
takes  everything  away  and  pushes  it  down  the 
bowels ;  he  heard  a  few  days  ago  a  signal  from  the 
soul  to  the  spleen  ;  the  soul  is  working  and  rubbing 
away  the  spots.  The  delusional  system  is  still  com- 
plete, and  its  integrity  is  but  little  affected. 

He  is  hypnotized  ;  post-hypnotic  suggestion  that 
the  lumps  will  jump  at  a  signal  to  the  hole  near  the 
spleen,  then  through  the  bowels  and  out  of  sight ;  he 
lies  down   upon  his  left  side  in  order  to  have  these 


Experimental  Data  233 

spots  go  in  the  hole  ;  he  feels  the  flesh  dry ;  feels 
the  spots  jump  to  the  arm,  and  then  to  the  head,  and 
then  to  both  holes,  both  behind  and  in  the  side ;  he 
cannot  tell  how  many  minutes  longer  it  takes.  When 
the  toes  flex,  the  lumps  come  up  on  the  anterior  sur- 
face of  the  leg  ;  when  they  extend,  they  come  up  the 
under  surface  of  the  leg. 

Second  hypnosis  was  easier ;  suggested  that  all  the 
spots  on  the  right  and  left  foot  would  disappear 
within  one  minute,  and  he  would  feel  much  happier 
after  awaking. 

Awaked,  he  said,  "  Some  one  in  my  dream  told 
me  to  count  the  spots  ;  I  can't  do  it,  for  they  are  all 
there  ;  I  would  like  to  have  them  all  go  ;  they  would 
all  go  through  the  holes."  After  two  minutes  he 
thinks  they  are  all  gone  except  a  few ;  when  asked  to 
guess  how  many  are  left,  he  holds  himself  in  an  atti- 
tude of  attention,  and  counts  to  twenty  on  the  right 
side,  and  to  ten  on  the  left.  Said  "  I  dreamed  that 
my  spots  will  go  right  away,  and  when  I  count  them 
they  go  quicker." 

February  2d  :  No  dreams  ;  diminution  of  spots  ;  be- 
lieves that  the  spots  are  worse  when  the  weather  is 
wet ;  thinks  it  will  take  a  long  time.  It  was  sug- 
gested in  hypnosis  that  after  awaking  he  would  see 
writing  upon  the  paper  and  read  it,  the  writing  being 
that  "  the  spots  are  going  fast."  When  reading  this  the 
spots  will  begin  to  go  much  faster.  After  awaking, 
he  says  "  I  cannot  count  them  "  ;  this  is  a  revival  of  a 


234  Psychopathological  Researches 

former  hypnotic  state  ;  he  said,  "  I  have  been  asleep, 
and  I  heard  some  one  say  for  me  to  read  upon  the 
paper  and  to  count  the  spots,  but  I  can't  read."  Re- 
hypnotized  with  post-hypnotic  suggestion  that  his 
father  would  speak  to  him  and  tell  him  that  he  would 
get  well,  and  after  awaking  he  would  speak  of  it 
to  P. 

He  awaked  and  said :  "I  saw  my  father  in  a 
dream,  and  he  told  me  that  my  feet  would  get  well 
and  dry,  whether  in  wet  weather  or  dry  ;  that  even  in 
damp  weather  I  would  be  well ;  my  father,  he  tells  the 
truth  "  ;  he  has  not  responded  to  the  latter  part  of 
the  suggestion,  as  to  telling  P.  about  his  increased 
strength  ;  only  that  which  interests  the  delusional  sys- 
tem in  question  is  adopted.     The  amnesia  is  complete. 

He  said,  "  If  my  memory  for  those  spots  would 
only  go  then  I  would  be  well."  Also  said  during 
hypnosis,  "  When  my  feet  get  dry  then  the  spots 
go  away."  The  upper  current  of  the  spots  to  the 
body  has  possibly  been  suggested  by  the  feeling  of 
the  electrical  current  up  the  legs  to  the  arms  and 
hands.  The  positive  tendency  towards  extension 
of  the  systematization  is  not  so  marked,  but  the 
negative  tendency  as  to  the  exclusion  of  any  ideas 
which  cannot  be  fused  is  still  strong. 

The  merry  hypnotic  state  is  now  markedly  dwin- 
dling away  and  the  patient  rapidly  passes  into  the 
grave  state,  now  greatly  moderated.  Patient  begins 
to  smile  in  his  grave  hypnotic  state.     There  seems 


Experimental  Data  235 

to  be  a  blending  of  the  two  contrasting  hypnotic 
states,  with  predominance  of  the  main  features  of  the 
second  state. 

February  8th  :  Says  his  father  has  told  him  the 
truth,  that  his  fingers  and  toes  are  getting  drier ; 
that  his  father  has  told  him  they  would  gradually  get 
drier.  But  they  are  not  yet  completely  dry.  This 
is  from  a  dream,  but  he  does  not  remember  at  what 
period.  In  hypnosis,  anaesthesia  of  the  left  hand  was 
suggested,  with  warmth  of  the  right  hand,  and  a 
negative  auditory  hallucination.  None  of  these  was 
successful  ;  apparently  they  were  too  numerous  for 
assimilation  by  his  delusional  system. 

In  second  hypnosis  it  was  suggested  that  when  a 
pencil  would  be  put  in  his  right  hand,  he  would 
answer  the  question  by  writing.  A  negative  auditory 
hallucination  involving  S.  was  given  that  he  would 
answer  S's  question  by  writing  without  remembering 
how  or  why.  He  was  distracted  by  P.  while  S.  spoke 
in  his  ear.  Patient  says  that  P.  has  asked  him  about 
his  sister.  It  was  really  S.  He  further  says,  "I 
can't  write  for  my  arm  hurts  me."  When  S.  speaks 
he  jumps  and  discontinues  any  conversation  with  P. 
In  third  hypnosis  there  was  insistence  on  writing  and 
the  negative  hallucination  of  S.  As  before,  he  says 
that  P.  is  speaking  to  him  about  his  sister,  about 
matches  ;  each  time  after  S.  speaks  to  him  he  lapses 
again  into  a  slight  hypnosis.  There  is  a  fixed  objec- 
tion to  writing.     Evident  lack  of  initiative.     When 


236         Psychopathological  Researches 

he  once  begins  he  finishes  completely  ;  he  said  he 
wrote  because  in  his  dream  he  was  told  to  write.  He 
said  he  heard  only  P.  Says  he  does  not  hear  S.,  but 
answers  S.,  explaining  that  it  is  P.  who  is  talking 
to  him.  He  insists  that  he  does  not  hear  S.,  but  only 
P.  Says  some  one  bothers  him,  meaning  S.  Patient 
looks  at  S.  and  then  turns  away  for  he  only  hears  P.; 
whenever  he  answers  S.  he  shuts  his  eyes  and  says  he 
is  talking  to  P.  He  takes  the  paper  and  says  that 
when  he  writes  upon  it  with  a  pencil  the  spots  will 
emerge  through  the  pencil  and  be  dropped  upon  the 
paper ;  he  refers  to  the  spots  upon  the  paper  made 
by  him  as  the  spots  which  have  emerged. 

He  tries  to  keep  this  paper ;  it  is  snatched  away, 
whereupon  he  gets  up  and  looks  for  it ;  he  talks  to 
S.,  yet  says  he  is  talking  to  P.  Says  he  does  not 
know  how  the  spots  get  away  with  the  paper,  but 
thinks  that  the  spots  have  carried  it  away.  When 
shown  some  spots  by  S.,  he  sees  them,  but  says 
they  are  not  the  ones.  It  was  further  suggested  in 
hypnosis  that  when  writing  he  will  see  the  spots 
come  off,  and  each  day  more  will  come,  and  each  day 
he  will  forget  more  about  the  spots  which  are  left. 
Also  insistence  upon  the  paternal  authority,  with 
verbal  repetition  ;  upon  awakening,  he  asked  who 
was  talking  to  him  in  a  dream. 

February  12th:  He  has  not  attempted  to  "write 
out  the  lumps,"  because  he  has  not  felt  like  writing  ; 
says  his  father  has  not  told  a  lie,  because  his  feet  are 


Experimental  Data  237 

becoming  a  little  drier,  but  not  entirely  so.  Hypno- 
tized, and  suggested  that  he  see  upon  awaking  a 
black  cat  with  a  white  tail ;  that  he  pet  the  cat,  and 
pull  her  tail.  On  awaking,  he  said  he  dreamed  of 
a  cat  once,  but  "this  (the  weight)  is  no  cat";  he 
says  it  is  simply  something  for  exercise ;  he  insisted, 
however,  that  he  wished  to  put  it  in  his  pocket,  but 
did  not  wish  to  steal  it.  This  is  from  the  previous 
hypnosis  of  two  weeks  past. 

Second  time  hypnotized  ;  suggested  he  would  see  a 
dog ;  on  awaking,  said  "  it  is  no  dog,  no  face  of  a 
dog,  does  not  look  like  a  dog  "  ;  exercises  with  the 
weight. 

Patient's  memory  of  the  motor  elements,  as  before, 
is  the  best ;  he  begins  to  exercise  with  the  weight  as 
before,  although  he  says  he  has  never  seen  it  before. 
Rehypnotized,  and  suggested  that  he  would  perceive 
a  snake  ;  the  snake  being  a  pneumographic  belt.  He 
looks  at  it  and  says  "  it  is  no  snake,  it  must  be  dead  ; 
my  worms  are  alive,  but  this  is  not  alive,  nor  is  it  my 
vein " ;  he  looks  at  it  very  frequently,  and  with 
questioning  and  uncertainty  ;  he  keeps  looking  at  it ; 
says  :  "I  don't  know  what  it  is,  but  I  am  scared  at  it, 
for  when  my  vein  came  I  was  scared  at  that ;  that 
thing  must  have  come  from  somebody  and  was  once 
alive,  and  so  I  am  scared  at  it  now,  and  I  shall 
throw  it  away."  There  is  here  a  complete  system- 
atization.  He  puts  it  away,  then  takes  it  out  and 
again  looks  at  it,  saying  each  time,  "  I  am  scared  at 


238         Psychopathological  Researches 

it";  then  he  says,  "Maybe  it  is  mine;  I  will  keep 
it  any  way  ;  it  can't  be  a  snake,  for  I  have  no 
snakes." 

When  shown  the  chain  connected  with  the  belt,  he 
said,  "In  my  body  I  have  such  a  piece  as  that.  Those 
dry  pieces  the  vein  would  take  by  signs  from  the  soul 
and  the  spleen."  He  did  not  appreciate  what  the 
flat  pieces  were, —  he  said,  he  "  did  n't  have  anything 
like  that ;  the  vein  had  a  mouth  something  like  this, 
but  not  just  quite "  ;  a  look  of  recognition  passed 
over  him  as  he  gazed  at  the  plate  ;  and  he  said, 
"  I  can't  exactly  remember  what  the  vein  had  here," 
pointing  to  the  plate,  "but  it  was  some  kind  of  a 
mouth." 

In  the  fourth  hypnosis,  amnesia  for  all  this  was 
complete. 

After  awaking  he  sees  no  use  in  the  weight ;  does 
not  regard  the  rubber  belt  as  the  vein  ;  he  looks  very 
happy  ;  there  is  evidently  complete  amnesia. 

February  16th  :  "Yesterday  the  spots  were  upon 
the  arm  and  the  head,  and  my  sleep  was  poor,  be- 
cause my  brains  are  mixed  up,  and  because  of  my 
memory  of  the  bad  feeling,  which  comes  back  when  I 
sleep  ;  after  I  wake  up  I  can't  remember  anything 
except  the  memory  of  the  bad  feelings."  He  has  slept 
poorly;  his  appearance  is  more  depressed.  Appli- 
cation of  electricity,  without  hypnosis,  suggesting  in- 
directly a  limitation  of  the  area  of  the  spots.  After 
the  application,  he  was  happy  and  laughing.      There 


Experimental  Data  239 

is  a  constant  reversion  to  the  manifestations  de- 
scribed earlier  in  the  course  of  the  disease.  The 
patient  passes  now  directly  into  the  deeper  grave 
state.  The  first  light,  "gay"  hypnotic  state  seems 
to  have  completely  dropped  out. 

The  idea  of  getting  advice  of  Dr.  N.  has  become 
fixed  in  the  mind.  He  reiterates  constantly,  "Will 
Dr.  P.  see  Dr.  N.  ;  it  is  in  my  head  and  I  must  see 
him,  for  it  is  always  in  my  mind  and  bothers  me." 
In  hypnosis  it  was  suggested  that  he  forget  Dr.  N., 
that  he  have  no  desire  to  see  him  or  any  one  else  ex- 
cept P.  ;  that  he  will  want  to  be  hypnotized,  that  he 
will  feel  better ;  that  all  the  spots  will  be  on  the 
right  foot,  and  that  on  awaking  he  will  feel  easy 
and  happy.  After  awaking  he  says,  "  I  do  not  care 
to  see  Dr.  N.,  I  have  no  desire  at  all  to  see  him."  He 
still  thinks  that  his  sleep  is  bad  for  him,  because  while 
he  is  sleeping  the  lumps  stay  still  and  do  not  move, 
but  he  sleeps  better,  because  his  "  brains  are  not 
mixed." 

February  21st:  "Two  days  after  I  left  here  the 
spots  begin  to  come  up  through  my  veins  and  to 
the  head,  and  then  I  feel  mixed  up  in  my  brain  and 
unhappy."  Lightly  hypnotized,  with  suggestion  of 
limitation  of  spots  as  before.  After  this  hypnosis  he 
began  to  feel  better,  saying  the  spots  begin  to  move 
more  to  the  hole  ;  "  When  I  walk,  the  spots  go  some- 
where else  and  not  to  the  hole,  but  when  I  lie  still 
they  go  to  the  hole  "  ;  there  was  no  mention  of  Dr.  N.; 


240         Psychopathological  Researches 

"when  the  spots  go  away  they  stay  away."  He 
says  that  whenever  he  tells  any  one  about  the 
trouble  in  the  past  he  feels  mixed  up  and  feels  that 
his  "  chest  wants  to  cry."  "  The  dreams  I  have  here, 
I  have  again  at  night ;  my  memory  of  the  past  is 
worse,  and  I  feel  very  unhappy  ;  when  I  walk  the 
spots  keep  still  and  when  I  sit  still  then  they  move." 
He  makes  a  line  of  demarkation  of  the  veins  which 
separate  the  small  toes  from  the  great  toe  ;  he  also 
says  that  as  the  spots  run  off  the  right  foot  they  also 
run  off  the  left. 

He  was  now  hypnotized,  and  for  the  first  time 
amnesia  of  the  delusion  was  attempted  ;  it  was  sug- 
gested that  the  delusion  would  be  rather  indistinct 
and  be  felt  as  a  past  experience ;  that  the  memories 
would  seem  so  long  ago  that  they  would  be  faint  and 
amusing,  that  they  would  seem  to  make  him  laugh 
without  knowing  why ;  that  he  will  never  dream  of 
them,  except  as  having  been  long  ago.  Special 
emphasis  laid  on  the  destruction  of  the  delusional 
spleen  and  soul ;  that  after  awaking  he  would  feel 
only  small  wet  spots  over  the  feet ;  that  there  would 
be  nothing  else,  no  feeling  of  the  soul  or  the  spleen, 
nothing  but  the  spots  ;  that  these  spots  would  make 
him  happy,  because  they  go  so  fast. 

Upon  awaking  he  was  laughing  and  happy  ;  said 
"I  had  a  good  sleep";  "this  is  the  first  time  my 
spots  are  going  out  when  I  sleep  ;  since  I  had  my 
trouble  of  last  year,  this  is  my  best  sleep  "  ;  this  is  due 


Experimental  Data  241 

apparently  to  the  suggestion,  now  successful,  of  par- 
tial amnesia  of  the  delusional  systems. 

Patient  asked  to  be  allowed  to  go  to  sleep  again  ; 
he  was  rehypnotized  ;  suggestion  of  small  wet  spots 
instead  of  lumps  ;  that  they  are  so  small  that  he  can 
hardly  notice  them  ;  that  they  are  amusing  him.  This 
is  an  attempt  to  remove  them  from  the  active  malevo- 
lent ideas  given  in  his  own  system  and  transfer  them 
to  pleasanter  groups.  Upon  awaking  he  again  was 
happy  and  laughing  and  said  :  "  They  run  off  very 
quickly  ;  I  don't  feel  mixed  up  ;  I  like  such  a  treat- 
ment for  I  slept  good  ;  my  toes  are  going  to  be  dry  ; 
the  spots  don't  stay  thick  but  thin  ;  I  am  soon  going 
to  be  well  and  happy  ;  I  wish  the  spots  would  move 
at  night  like  they  do  now  ;  I  feel  light  on  my  feet  ; 
I  feel  bright  and  strong  "  ;  he  was  brighter  than  ever 
before. 

The  "gay"  emotional  personality  no  longer  emer- 
ges. Attempt  at  disaggregation  ;  amnesia  as  to  the 
past ;  transfer  or  metamorphosis  by  means  of  asso- 
ciation with  pleasant  emotional  states.  It  was  sug- 
gested the  spots  be  absolutely  limited  to  the  foot ; 
that  they  are  simply  small  wet  spots  which  get  dry 
as  they  go  to  the  hole  ;  attempt  to  make  these  sensa- 
tions less  and  less  focal. 

Suggested  first  that  the  past  memories  are  funny  ; 
that  the  spots  are  amusing  him ;  that  they  are  not  un- 
pleasant. The  task  is  to  limit  the  wide  systematization 
which  has  taken  place,  pleasant  groups  of  systems  are 


242         Psychopathological  Researches 

continually  to  be  assimilated  to  the  old  systems,  sub- 
stituting themselves  for  portions  of  the  old. 

February  26th:  He  says  "the  spots  do  not  go  to 
the  hole  when  I  walk,  only  when  I  lie  down  ;  the 
spots  are  hardly  felt,  they  are  now  only  slightly 
wet  or  dry ;  but  on  the  head  there  are  sometimes 
spots  when  they  come  up,  that  is,  when  the  wet 
comes  up,  it  dries  out  and  makes  the  spot."  This  state- 
ment is  elicited  upon  a  question  as  to  how  there  could 
be  spots  on  the  head,  when  there  are  no  spots  on  the 
feet,  but  only  wetness.  It  is  simply  a  question  of  de- 
velopment of  existing  systems  in  the  patient.  He  pro- 
ceeds to  say,  "  When  I  sit  still  then  these  dry  spots  go 
to  the  hole  ;  if  I  walk  they  go  to  the  head  and  from 
there  to  the  hole  ;  I  don't  think  over  my  troubles  any 
more,  I  have  pretty  near  forgotten  them  ;  it  is  no  use 
to  me;  I  don't  get  nervous  any  more."  In  hypnosis 
the  same  suggestion  of  the  pastness  of  the  delusion 
was  given  to  him,  associated  with  a  pleasant  affect- 
ive state  as  to  the  present  sensations  ;  also  suggestion 
of  indistinctness  of  the  wet  area  over  the  feet ;  also 
for  the  first  time  associated  this  wetness  with  the  idea 
of  sweating.  Suggested  that  the  wet  must  be  sweat ; 
that  it  is  so  slight  that  it  is  rather  amusing  ;  that  it 
is  so  slight  that  it  cannot  go  above  the  feet,  to  the 
head  or  to  the  body  or  to  the  arms  ;  that  it  runs 
off  waking  or  lying  still ;  that  the  spots  must  have 
been  wet  like  sweat ;  that  all  the  wetness  he  has  had 
must  have  been  wet  sweat.     His  sleep  is  deep.    Upon 


Experimental  Data  243 

awaking  he  says  that  "  the  feet  are  only  wet  with 
wet  sweat,  that  it  can't  go  anywhere  else ;  that  when 
they  get  warm  they  will  be  cured,  that  it  runs  off  so 
fast  to  its  hole  that  I  can  feel  it."  The  attempt  to 
limit  the  spots  to  the  feet  and  to  create  a  new  system 
for  the  dispersal  of  the  sweat  did  not  work ;  the  old 
systems  are  still  strong  and  cannot  at  present  be 
disturbed. 

After  hypnosis  he  further  said  he  did  not  feel  so 
much  running  off  because  not  much  was  left  to 
run  off  ;   he  was  getting  better. 

March  2d  :  "Am  getting  better ;  for  two  days  after 
leaving  here  everything  was  all  dry,  then  when  the 
weather  changed,  a  little  sweat  came  under  the  nails 
and  a  little  on  the  face,  just  like  sweat ;  it  seems  to 
be  different  than  before,  it  is  more  like  sweat ;  it  still 
feels  like  an  inside  wet "  —  he  cannot  just  tell ; 
he  does  not  feel  it  as  he  did  before  because  it  does  not 
collect ;  he  cannot  tell  where  it  comes  from  ;  feels 
more  happy,  and  wants  to  get  up  and  go  to  work ; 
says  he  dreams  about  business,  but  cannot  remember 
what  it  is  ;  says  he  feels  differently ;  says  he  can  read 
now,  and  that  it  does  not  bother  him  so  much,  that  he 
can  talk  more  to  people  ;  he  does  not  remember  about 
the  "past  sickness,"  and  when  he  tries  to  remember, 
he  feels  he  cannot.  The  wet  does  not  trouble  him — 
says  he  can  stand  it.  In  hypnosis,  suggestions  as 
before  ;  that  the  delusion  is  an  experience  of  the  past ; 
that  the  wetness  is  on  the  outside  just  like  wet  sweat, 


244         Psychopathological  Researches 

that  the  inside  wet  seems  "long  ago";  is  nearly  for- 
gotten ;  that  the  outside  wet  is  on  the  toes,  none  on 
the  body,  that  it  runs  off  like  sweat ;  that  he  will 
think  of  business ;  that  he  will  feel  happy  and  strong. 

March  5th  :  "  I  am  getting  better  ;  all  my  trouble  is 
now  '  in  '  the  toes  and  feet ;  simply  the  toes,  not  the 
feet  any  more,  just  underneath  the  nails";  he  feels 
"  no  more  wet,  just  little  spots  of  dryness.  Now  it 
moves  up  to  the  body  dry,  it  does  not  go  up  wet.  I 
cannot  feel  the  wet  places  any  more  for  something 
dry  comes  up  from  the  toes."  The  dry  feeling  is  like 
sweating,  but  still  "inside  sweating";  the  dry  spots 
come  up  the  body  and  get  warm  and  then  pass  away  ; 
his  hole  is  closing  up,  and  when  that  closes  up  then 
things  will  be  over ;  he  thinks  it  will  be  shut  in  a 
week's  time  ;  "  things  are  going  out  rapidly  "  and  he 
is  getting  fleshy  ;  "  the  hole  has  no  chance  to  close  up 
until  the  spots  stop  coming  out." 

He  says  that  when  he  wakes  up  in  the  morning 
"  there  is  nothing  on  the  body,  it  stays  only  on  the 
toes  ;  they  are  just  dry  spots,  not  wet "  ;  that  when 
he  wakes  up  his  face  is  bright  and  he  feels  good  ; 
that  when  he  comes  into  a  warm  room  "  something 
goes  to  his  head."  In  talking  he  combats  the  idea 
of  sweat  being  the  same  as  the  wetness,  that  his  wet- 
ness cannot  come  outside,  as  his  sweat  does ;  that  "  it 
must  go  out  through  the  inside  ";  this  apparently 
explains  the  inability  to  fuse  by  suggestion  "  inside  " 
and  "outside"  sweat ;  it  is  necessary  to  follow  as  yet 


Experimental  Data  245 

along  the  lines  of  least  resistance ;  patient  says  the 
"spots  will  get  less  and  less,  and  then  the  wet  and  the 
warm  of  the  body  will  go,  and  my  hole  will  close  ; 
whatever  comes  up  in  the  body  gets  wet  and  warm 
and  then  goes  out  through  the  hole." 

Patient  says  that  "the  holes  are  so  very  little  the 
spots  must  go  in  now  more  rapidly,  because  they  have 
to  be  soft  and  warm  to  get  in  "  ;  asked  what  side  the 
spots  go  in,  says  "  they  go  inside  to  the  front ;  then 
sometimes  in  the  back  side ;  but  now  all  go  in  one 
hole  in  front  upon  the  left  side." 

In  hypnosis  the  suggestions  as  before  were  directed 
toward  making  the  delusion  a  past  experience  ;  the 
spots  to  be  limited  to  two  toes  only,  that  they  are  to 
be  so  small  that  they  can  only  go  to  the  one  hole, 
taking  the  course  back  of  the  knee  to  the  thigh, 
and  thence  to  the  hole.  This  route  he  had  described 
while  in  his  waking  state.  Further  suggested  that 
the  hole  is  closing  ;  that  in  two  days  only  one  toe  will 
be  left  "  dry  "  ;  that  he  is  fast  getting  well ;  amnesia 
as  to  the  other  hole ;  continuous  thinking  of  the 
route  of  the  spots  while  in  hypnosis  ;  that  after  awak- 
ing he  will  feel  it ;  that  the  dry  spots  will  go  every 
day ;  that  then  the  wet  and  the  warm  of  the  body 
will  diminish,  and  he  will  feel  the  hole  close.  Feels 
fine  and  strong  on  awaking. 

March  9th  :  "  I  feel  better  than  ever  before  ;  I  feel 
the  spots  on  the  toes  very  dry,  they  did  not  run  ; 
beginning  with  to-day  they  began  to  move  ;  they  went 


246         Psychopathological  Researches 

direct  to  the  hole ;  now  the  hole  is  beginning  to 
close "  ;  on  the  last  two  days,  after  his  former  hyp- 
nosis, these  feelings  were  less  indistinct,  due  to  the 
apparent  reappearance  of  the  more  stable  systems. 
"  Only  one  toe  is  sick  now,  just  one  ;  others  are  warm 
and  dry,  but  they  are  made  sick  because  of  the  sick 
one ;  if  the  sick  one  becomes  well,  then  all  will  be  well." 
He  feels  in  the  sick  one  something  like  squeezing 
and  heat ;  feels  like  a  nail  pulling ;  he  shows  the 
foot.  Over  the  toe  that  is  sick  is  the  last  of  the 
wet  spots  ;  "  I  had  them  on  two  toes  last  time  ;  now 
it  is  dry,  and  all  that  is  left  is  cold  and  dry  "  ;  as  his 
toes  move  he  says,  "  There,  it  is  working  ;  I  don't 
feel  it  move,  only  when  I  look  at  it  I  know  it  moves." 
The  kinesthetic  sensations  were  tested  at  this  time 
and  found  normal.  Though  he  says  he  feels  more  in 
the  other  toes  than  in  the  sick  one,  no  hypoaesthesia 
can  be  demonstrated. 

In  hypnosis,  suggestion  as  before  ;  localization  of 
spots  to  one  toe  ;  to  be  warm  and  dry ;  to  run  off 
by  one  route  along  the  inside  of  the  thigh  to  the 
hole,  with  subsequent  gradual  closure  of  this  hole. 
That  the  spot  on  the  sick  toe  is  so  little  that  it  can 
only  effect  the  toe  next  to  it,  and  no  farther. 

March  21st:  Patient  has  been  ill  with  a  genuine 
attack  of  influenza  ;  it  is  significant  that  the  decided 
change  in  the  painful  tone  of  organic  sensations  did 
not   produce    any    reinstatement  of  former  systems. 

He  says  that  now  all  his  "weakness  is  still  in  the 


Experimental  Data  247 

second  toe ";  that  any  sensations  in  the  other  toes 
originate  from  this  one.  That  the  coldness  under 
the  nails  of  the  other  toes  is  less.  It  runs  off  to  the 
body  during  motion  and  only  to  the  hole  during  rest. 
There  is  still  a  tendency  to  assimilation  by  the  de- 
lusional system.  It  was  suggested  that  he  would 
have  no  more  bad  dreams,  that  his  dreams  would  be 
pleasant  and  happy.  In  this  hypnosis  he  tells  of  a 
former  dream  of  breaking  a  bottle  of  medicine,  and 
being  told  by  some  doctor  not  to  take  that  medicine  ; 
after  awaking  in  the  morning  he  remembered  the 
bottle  described,  and  did  not  feel  like  taking  that 
medicine,  because  in  the  dream  it  had  been  told  him 
not  to  do  so,  "because  it  drew  in  the  spots  on  the 
stomach."  Here  is  a  revival  of  the  old  systems  about 
which  amnesia  had  been  enforced.  Nothing  had 
been  said  of  these  stomach  spots  for  months ;  there 
was  some  resemblance  of  the  doctor  in  the  dream  to 
the  Dr.  N.,  the  idea  of  seeing  whom  had  formerly 
been  fixed  and  had  later  to  be  removed  by  hypnosis. 

In  this  hypnosis  it  was  again  suggested  that  the 
spots  go  to  the  hole  and  that  they  must  close  the 
hole,  and  that  as  the  hole  needs  them  they  can  go 
nowhere  else.  Amnesia  as  to  the  doctor  in  the 
dream  insisted  upon  ;  further  suggested  the  spots 
will  not  spread  from  the  sick  toe  ;  that  they  are  to 
run  off  to  the  hole  whether  he  be  walking,  riding,  or 
sleeping,  that  they  will  run  only  to  the  hole. 

March  26th  :     One  toe  and  between  the  first  and 


24S  Psychopathological  Researches 

second  toe  is  still  "  sick."  "  The  spots  still  run  to  the 
body  ;  I  think  about  it  and  it  runs  to  the  hole,  and 
the  spots  must  close  the  hole  ;  I  have  this  in  my  mind. 
As  I  think  of  this  it  runs  up  faster ;  it  must  run  dry 
very  soon,  as  the  toe  could  not  hold  very  many  more 
spots  ;  it  does  not  get  any  worse  in  bad  weather.  My 
right  arm  begins  to  feel  better,  therefore  the  spots 
must  be  running  rapidly  to  the  hole,  even  though  I 
do  not  feel  them.  If  I  think  of  anything  else  the 
idea  of  the  spots  comes  in  and  stops  my  thinking  ; 
it  does  not  make  me  sad  any  more,  because  when  I 
think  about  it  the  spots  move  faster." 

In  hypnosis  it  is  suggested  that  only  at  night  will 
the  spots  be  felt,  not  during  the  day,  that  the  toe  is  so 
nearly  dry  the  spots  run  only  at  night ;  that  he  will 
be  free  to  think  of  business. 

March  30th  :  "I  am  getting  better,  the  spots  run 
very  little,  mostly  during  the  night ;  in  the  daytime  it 
moves  to  the  body  and  not  to  the  hole."  The  appre- 
ciation of  sensation  is  becoming  less  distinct  in  the  toe. 
Says  he  has  dreamed  of  hearing  and  seeing  Dr.  P.,  also 
of  Dr.  P.  telling  him  that  unless  the  spots  went  soon 
the  toes  must  be  cut  off.  In  the  morning  following 
this  he  felt  the  spots  less ;  there  was  suggested  by 
hypnosis  a  dream  content ;  that  he  would  hear  and 
see  Dr.  P.  tell  the  spots  to  go  only  to  the  hole  and 
not  to  the  body,  and  only  at  night ;  and  that  he  was 
getting  well. 

April  2d  :  "  Mind  is  getting  better,"  feels  free  in  the 


Experimental  Data  249 

daytime ;  spots  run  during  the  night ;  dreams  at 
night  pleasant,  but  cannot  remember  them  ;  there  is 
no  more  heavy  feeling,  because  the  spots  run  to  the 
hole  ;  he  does  not  feel  them  run  to  the  hole  and  does 
not  really  feel  the  hole.  Suggestions  are  continued 
as  before.  The  patient  said  that  he  had  something 
he  wished  to  tell  me  of.  Dr.  S.  thought  it  possible 
that  there  might  still  exist  a  fixed  nuclear  idea ; 
after  hypnosis,  the  question  proved  to  be  not  any- 
thing focal,  but  simply  a  slight  development  of  a 
system  involving  sensory  elements  proceeding  from 
the  rectum,  the  origin  of  which  could  be  traced  to  a 
question  by  P.  ten  months  previous  in  regard  to  the 
second  opening.  Following  this,  amnesia  of  the  pre- 
vious experiences  was  suggested. 

April  6th  :  "  Since  I  had  the  cold  in  the  throat  it 
moves  in  the  daytime  again."  Patient  had  had  a 
slight  pharyngitis.  This  additional  disturbance  of 
sensation  has  been  sufficient  to  redevelop  the  re- 
cently limited  systems.  On  questioning,  it  was  found 
that  the  patient  had  developed  this  idea  from  his 
belief  that  "the  spots  in  the  toe  came  from  cold," 
therefore  with  a  new  cold  the  spots  will  redevelop. 
It  is  necessary  to  limit  not  only  the  delusion  as  to 
time  and  place,  but  also  under  all  conditions,  as  in 
a  former  case  of  wet  and  dry  weather,  which  at  one 
time  constituted  a  large  factor.  Suggestions  in  hyp- 
nosis were  made  especially  emphatic  towards  elimi- 
nating the  influence  of  the  sore  throat. 


250  Psychopathological  Researches 

April  2 1  st :  The  spots  have  been  moving  fast,  and 
since  they  have  been  doing  so  they  must  come  from 
somewhere,  otherwise  the  demand  would  outrun  the 
supply ;  he  describes  their  source  as  between  the 
toes  ;  he  does  not  feel  the  hole  any  more,  simply 
feels  the  running  off ;  says  he  feels  happy,  because  he 
knows  where  they  come  from.  "  Spots  don't  stop  in 
the  toe  at  all,  and  the  only  place  they  do  stop  is 
between  the  toes." 

In  hypnosis  it  was  suggested  that  the  excessive 
running  off  was  due  to  the  constant  application  of 
the  battery,  with  the  repeated  suggestion  that  they 
were  running  into  the  electrode  ;  that  as  the  spots 
disappeared  from  the  end  of  the  toes,  those  farther 
up  would  follow  ;  the  spots  to  disappear  entirely. 

April  28th :  Condition  improving ;  same  sugges- 
tions as  before  ;  spots  are  now  very  deep  and  very 
few  ;  they  have  been  going  fast  all  the  week  to  the 
hole  ;  dreamed  of  hearing  Dr.  P.  say,  "  you  are  well 
and  dry."  And  the  next  morning  awoke  happy ; 
since  then  the  toes  have  remained  dry  ;  in  hypnosis, 
same  suggestions,  with  special  emphasis  directed  to 
the  dream  life. 

May  5th  :  Since  suggestion  as  to  the  limitation  of 
spots  to  one  toe  has  been  omitted,  there  has  been  a 
consequent  extension  to  the  other  toes  or  metatar- 
sal spaces.  Tendency  for  the  systems  to  redevelop. 
In  the  remaining  three  outer  spaces,  the  spots  remain 
on  the  "  mucous  membrane,  but  not  on  the  toes  ;  there 


Experimental  Data  251 

is  nothing  more  on  the  flesh,  but  only  in  the  mucous 
membrane."  As  he  sat  looking  at  his  foot  he  noticed 
the  pulsation  of  an  artery  ;  he  immediately  assimilated 
this  into  his  delusional  system  as  being  "  a  spot  which 
was  running  off."  He  has  dreamed,  but  remembers 
only  of  dreaming  that  "the  last  spot  in  my  well  toe 
went  out  through  my  ear." 

He  now  thinks  that  there  is  some  unnatural  power 
that  removes  the  spots,  and  he  consequently  cannot 
think  of  anything  else.  This  is  again  a  novel  system- 
atization,  incorporating  the  idea  of  the  battery  as  the 
power.  At  times  as  the  patient's  toes  move,  he  de- 
clares he  cannot  feel  them  move, — "that  it  is  only 
the  spots  running  off  which  move  the  toes."  No 
kinesthetic  anaesthesia  can  be  demonstrated. 

May  1 2th  :  He  feels  much  better  ;  he  thinks  there 
is  but  little  left  to  do ;  he  cannot  feel  where  the  spots 
are ;  they  are  rather  scattered,  and  the  only  time  that 
he  can  localize  them  is  when  lying  down  ;  he  is  not 
so  tired  ;  he  thinks  they  will  be  gone  in  a  week, 
because  he  has  promised  a  friend  that  this  will  be  the 
result. 

In  hypnosis,  the  suggestion  formerly  given  as  to 
the  scattering  of  the  spots  and  their  indistinctness  is 
continued. 

May  19th  :  Spots  only  under  the  nails  now  and  they 
run  off  very  rapidly,  especially  during  warm  weather. 
In  hypnosis,  as  the  current  was  applied,  it  was  sug- 
gested that  the  spots  were  all  to  go,  that  the  flesh  was 


252  Psychopathological  Researches 

to  feel  natural ;  that  he  is  not  to  be  able  to  remember 
the  spots,  simply  to  remember  that  there  was  some- 
thing there,  and  that  it  is  gone.  After  awaking, 
amnesia  incomplete. 

May  26th  :  He  comes  in  smiling  and  bright;  says 
he  feels  almost  well ;  says  he  can  feel  the  spots  no 
more,  but  just  a  little  wetness  :  substitution  here  of 
the  "wetness"  for  the  "spots."  The  wetness  is  very 
little  ;  for  the  past  week  he  has  kept  his  toes  in  the 
sunlight  —  thinks  it  helps  spots  to  come  out.  This 
additional  system  involving  spots  coming  out,  as  the 
effect  of  the  sun,  is  partially  the  result  of  previous  sug- 
gestion. He  says  "  I  feel  the  flesh  on  my  toes  like  it  is 
everywhere  else,  only  it  is  slightly  wet ;  I  feel  that  the 
spots  never  can  come  back,  because  the  power  gets 
everything  out."  The  "power"  is  still  substituted 
for  the  former  "spirit"  and  "soul."  Says  the  wetness 
is  but  slight.  He  says  his  "toes  look  skinny  now, 
because  the  spots  are  gone  ;  when  the  spots  were 
there,  they  were  swollen."  In  hypnosis,  the  period  of 
happiness  and  joy  was  again  prolonged ;  says  he 
cannot  sleep  because  he  is  "  so  happy  and  so  near 
well."  The  suggestions  were  continued  as  to  the 
elimination  of  the  wetness  ;  as  to  the  natural  feeling 
of  the  flesh  ;   as  to  the  amnesia  of  the  spots. 

June  2d  :  For  two  days  the  wetness  has  moved  so 
much  that  he  had  to  lie  down  ;  in  only  two  toes  is  the 
wetness  warm,  and  it  is  very  slight ;  he  says  it  runs 
occasionally   to  the  head.     The   former  suggestions 


Experimental  Data  253 

that  the  spots  run  to  the  hole  had  been  omitted,  with 
insistence  upon  amnesia  as  to  the  hole. 

July  2d  :  Certain  systems  still  persist ;  apparently 
based  upon  some  definite  sensory  condition,  described 
as  coldness  and  numbness  of  the  extremities ;  the 
left  foot  is  warm,  but  the  toes  of  the  right  foot  are 
definitely  cold  to  the  touch.  There  is  no  reappear- 
ance of  former  systems. 

July  1 2th  :  Says  his  "toes  feel  natural  like  flesh, 
in  every  kind  of  weather;  I  feel  only  wetness;  the 
wetness  goes  to  the  bowels  and  then  away."  The 
improvement  in  regard  to  the  character  of  sensations 
is  definite,  as  evidenced  by  his  statement  that  he  now 
"feels  the  flesh."  In  hypnosis,  suggestion  has  pro- 
ceeded on  the  line  of  the  removal  of  the  wetness  to 
the  bowels,  emphasizing  by  means  of  pressure  on  the 
abdomen  ;  absolute  amnesia  being  enforced. 

October  8th  :  He  felt  better  last  week,  toes  felt 
warmer ;  he  worked  ;  felt  nothing  in  his  body  ;  since 
Sunday  the  wetness  has  run  to  the  bowels,  has  had  a 
slight  sore  throat ;  says  he  fancies  that  "  the  cold  air 
has  pulled  the  wetness  from  the  toes  to  the  throat, 
just  as  by  a  magnet."  The  systems  have  not  been  as 
yet  entirely  demolished.  There  is  certainly  a  cold- 
ness very  marked  in  both  extremities.  Blood  analysis 
shows  slight  anaemia.  In  deep  hypnosis,  an  attempt 
at  heightening  the  temperature  of  extremities  was 
unsuccessful. 

October  15th  :     Patient  says  that  "there  is  a  little 


254         Psychopathological  Researches 

wetness  only  in  the  centre  toe  ;  can't  feel  it  very  well ; 
does  not  notice  it  much  "  ;  that  when  he  does  not 
notice  it  "  it  runs  away  most  probably."  "Occa- 
sionally the  spots  run  to  the  body  and  thence  to  the 
bowels ;  they  are  not  the  old  spots,  for  I  cannot  re- 
member them ;  if  I  try  to  tell  about  them,  it  does 
not  come  ;  it  is  now  only  in  one  of  my  toes,  and 
nowhere  else  ;  I  am  getting  better  all  the  time,  I  feel 
stronger  and  heavier ;  the  power  still  works  in  me  at 
night,  and  draws  the  spots  from  the  toes  to  the 
bowels  ;  only  when  I  am  tired  during  the  day  does 
this  happen." 

The  patient  has  been  seen  from  time  to  time,  the 
last  vestiges  of  his  delusional  system  have  entirely 
disappeared.  He  is  now  in  a  normal  mental  con- 
dition ;  has  resumed  his  work  under  his  old  employer ; 
has  been  advanced  to  the  position  of  foreman  and 
has  given  entire  satisfaction. 


Mental    Dissociation 
In 
Functional    Motor    Disturbances 

By 

George  M.   Parker 


CHAPTER  I 

HISTORY    AND     EXAMINATION 

Cases  of  motor  disturbances  apparently  due  to  no 
organic  cause  are  becoming  more  frequently  noted  in 
psychopathological  literature.  While  possessing  their 
own  individual  features,  all  such  cases  present  certain 
elements  in  common,  to  which  we  would  direct  the 
reader's  attention. 

Miss  A.,  the  patient,  is  twenty-five  years  of  age. 
The  family  history  contains  certain  determining  fac- 
tors. The  paternal  grandmother  is  described  as  hav- 
ing been  a  willful,  unmanageable  individual.  The 
patient's  father  possesses  many  traits  apparently  de- 
rived from  this  genealogical  branch.  He  is  highly 
emotional,  excessively  sentimental,  readily  unbal- 
anced, a  very  poor  sleeper,  an  active  dreamer,  though 

255 


256         Psychopathological  Researches 

not  somnambulistic.  Maternal  side  presents  no  point 
of  interest.  To  neither  side  can  presence  of  definite, 
transmitted  disease  be  traced. 

Personal  history  details  an  almost  complete  ab- 
sence of  ordinary  somatic  diseases  of  childhood  and 
adolescence, —  no  diphtheria,  no  scarlatina,  no  rheu- 
matism, no  cholera,  no  trace  of  tuberculosis  either 
pulmonary  or  articular,  no  anaemia,  no  trauma.  Men- 
struation was  established  at  the  age  of  sixteen  ;  it  has 
been  regular,  though  occasionally  painful. 

Further  investigation,  however,  discloses  the  devel- 
opment of  certain  innate  peculiarities,  further  ac- 
centuated by  the  action  of  environing  conditions. 
Primarily,  the  resemblance  to  her  father  is  marked. 
As  a  child  the  patient  was  bright,  but  entirely  lacking 
in  persistency  of  purpose  and  action.  The  patient  is 
described  as  irresponsible  and  eccentric.  As  posses- 
sor of  a  brighter,  if  less  responsible,  mind  than  the 
sister,  her  life  has  been  that  of  constant  favoritism, 
with  the  consequent  wider  divergence  of  these  pri- 
mary deviations.  Succeeding  years  have  exaggerated 
rather  than  ameliorated  these  peculiarities.  Of  es- 
pecial interest  is  the  undoubted  existence  of  som- 
nambulistic tendencies  in  childhood  persisting  up  to 
adolescence.  Her  dream  life  has  been  active ;  con- 
tent of  dreams  is  distinctly  unpleasant. 

The  accident,  initiating  the  present  illness,  occurred 
two  years  ago.  It  was  apparently  a  simple  sprain,  in- 
duced by  foot  turning,  while  walking  a  heavy  country 


History  and  Examination  257 

road  in  a  light  house  slipper.  Considerable  pain  at- 
tended the  accident.  There  was  the  usual  swelling, 
tenderness,  etc.,  with  no  evidence  of  a  fracture.  Or- 
dinary methods  for  reduction  of  swelling  were  em- 
ployed followed  by  applications  of  a  Gibney  plaster. 
Although  the  foot  apparently  mended  exceedingly 
well,  the  physician  in  attendance  was  greatly  puzzled 
by  the  excessive  general  pain  declared  by  the  patient 
as  accompanying  the  slightest  movement.  Frequent 
readjustment  of  the  straps  failed  to  remedy  this  con- 
dition. Patient  finally  attempted  to  walk  after  re- 
moving straps.  She  succeeded  only  in  augmenting 
the  symptoms.  At  this  point  she  was  advised,  one 
month  after  the  accident,  to  employ  crutches.  Since 
this  time,  she  has  continually  used  them.  At  the  end 
of  three  months,  patient's  condition  was  unchanged. 
The  swelling  was  slight,  but  the  pain  was  excessive. 
The  medical  adviser  again  insisted  upon  patient's 
walking.  A  commiserating  family  and  diminishing 
initiative  defeated  him.  As  the  Gibney  straps  were 
still  maintained,  walking  with  the  leg  suspended 
naturally  produced  a  slight  degree  of  stasis  in  the  toes. 
Its  increase  was  very  gradual  until  six  months  later. 
During  this  interim,  the  patient  had"  seen  several  sur- 
geons in  New  York,  both  general  and  orthopaedic. 
Their  diagnoses  were  largely  negative,  but  the  ques- 
tions directed  to  the  patient  made  a  deep  impression 
on  her.  At  this  time  the  persistency  of  the  pain, 
coincident  with  a  marked  increase  of  the  oedema,  led 


258         Psychopathological  Researches 

to  her  admission  to  the  hospital.  The  oedema  was 
not  confined  to  the  foot,  but  invaded  the  leg  to  the 
region  of  knee.  Shortly  after  admission  to  hospital, 
a  distinct  bluish  coloration  appeared  at  the  toes,  ex- 
tending upward  and  over  the  area  of  the  oedema. 
CEdema  and  coloration  controllable  only  by  elevation 
of  foot.  Foot  gradually  assumed  position  of  equino- 
valgus.  Repeated  examinations  of  foot  by  the  sur- 
geons could  disclose  no  articular  lesions.  A  plaster 
cast  was  applied  to  prevent  further  deformity.  The 
patient  was  seen  by  a  consulting  neurologist,  and  the 
opinion  of  hysteria  was  advanced.  From  this  time, 
galvanization  and  massage  were  intermittently  applied. 
Contrary  to  advice  of  surgeons,  patient  refused  to 
leave  until  one  year  after  admission.  Her  condition, 
when  discharged,  was  unimproved. 

Previous  to  discharge,  a  skiagraph  of  the  joint  re- 
vealed an  apparently  normal  condition,  both  of  the 
bone  and  membrane.  It  was  my  good  fortune  to  see 
this  case  directly  after  patient's  discharge  from  hospital. 
The  joint  in  question  presented  a  rather  startling  ap- 
pearance, both  in  its  relative  and  real  position.  It 
rested  upon  a  level  higher  than  the  patient's  head  ; 
the  only  level  in  which  it  could  be  maintained  without 
the  appearance  of  oedema.  The  position  assumed  was 
that  of  marked  equino-valgus. 

There  was  no  swelling  about  the  joint.  Bony 
prominences  were  distinct.  Examination  produced  a 
characteristic   display.     At  whatever  point    pressure 


History  and  Examination 


259 


FIGURE  26. 


might  be  exerted,  an  exceedingly  vigorous  reaction 
was  manifested.  Especially  was  this  true  over  the 
malleoli,  os  calcis,  along  the 
entire  extent  of  the  tibia, 
—  in  short,  wherever  bony 
structures  were  superficial 
and  apparent  to  the  touch. 
The  focus  of  greatest  in- 
tensity could  readily  be 
varied  by  diversion  of  at- 
tention. A  similar  varia- 
bility of  reaction  was  noted 
towards  stimuli  of  touch, 
pain,  and  temperature.  Over  the  mesial  surfaces  of 
the  foot,  the  reaction  was  rather  delayed  than  dimin- 
ished. Hypoaesthesia  was  demonstrable  in  kines- 
thetic sensibility.  Passive  motion  was  impossible, 
every  attempt  to  move  foot  apparently  producing 
great  pain.  The  joint  furthermore  was  exceedingly 
rigid,  antagonistic  muscle  groups  being  decided  agents 
in  this  result.  Active  motion  exhibited  only  a  feeble 
movement  of  the  toes.  This  slight  movement  was 
accompanied  by  violent  protestations  of  inability, 
with  equally  violent  contractions  of  opposing  muscle 
groups. 

After  a  brief,  but  painful  struggle,  the  equilibrium 
between  flexion  and  extension  was  disturbed,  with  re- 
sultant production  of  slight  movement.  There  was 
considerable  atrophy  of  the  posterior  parts  of  the  leg. 


260  Psychopathological  Researches 

No  suspicion  of  tubercular  disease  could  be  enter- 
tained after  examination  of  the  joint,  although  by 
direct  questioning,  grounds  for  almost  any  diagnosis 
could  be  obtained.  Demonstration  of  oedema  was 
readily  afforded  by  lowering  the  level  of  the  foot. 
It  rapidly  appeared,  beginning  in  the  toes,  and 
extended  upward  to  the  knee,  a  dark  bluish  colora- 
tion immediately  following,  its  limits  being  cotermin- 
ous with  those  of  the  oedema.  This  coloration  was 
general ;  it  was  not  preceded  by  sudden  pallor.  Slight 
drop  in  local  surface  temperature  was  evident.  Con- 
siderable pain  accompanied  the  appearance  of  oedema 
and  coloration.  There  was  no  bilateral  display  of 
these  symptoms  at  this  time,  no  tenderness  along  the 
course  of  nerves.  There  was  gradual  disappearance 
of  all  symptoms  upon  re-elevation  of  foot. 


CHAPTER   II 

THE    PSYCHIC    TRAUMA 

In  the  consideration  of  this  case,  there  is  primar- 
ily traceable  from  grandmother  to  granddaughter, 
through  the  father,  a  tendency  towards  similar  dis- 
proportionate reactions  under  approximately  similar 
conditions.  This  tendency,  which  presumably  in 
grandmother  and  in  father  did  not  approximate  a 
psychopathic  condition,  has  definitely  reached  this 
point  in  the  present  case.  In  her  father  the  dream 
life  has  been  exceedingly  active,  with  disproportionate 
influence  upon  waking  states.  In  the  patient  this 
activity  developed  into  somnambulism.  This  per- 
sisted to  the  patient's  fifteenth  year.  The  character 
of  the  trances  was  not  recalled,  except  in  regard  to 
their  general  tone,  which  was  decidedly  unpleasant. 

Revival  of  these  states  was  not  attempted,  because 
of  limitations  placed  by  family.  The  persistence, 
therefore,  of  dominating  subconscious  memories  could 
not  be  demonstrated.  Patient's  history,  previous  to 
accident,  can  be  briefly  reviewed.  The  general  tone 
of  her  life  was  idle  and  purposeless.  Further,  there 
were  no  somatic  diseases  of  an  exhausting  type  which 

at  times  precede   as   agencies  of  a  causative  series. 

261 


262  Psychopathological  Researches 

The  manner  of  the  determining  accident  has  been 
previously  detailed.  A  slight  sprain,  usually  invalid- 
ing one  for  a  period  of  seven  to  ten  days,  in  this  case 
produced  conditions  persisting  for  two  years.  The 
preceding  history  of  the  joint  was  not  of  a  nature  to 
warrant  such  a  reaction  as  the  result  of  an  even  more 
severe  strain.  The  degree  of  stress  to  which  the  joint 
was  subjected  certainly  was  alone  insufficient  to  pro- 
duce the  result.  The  main  factors  were  evidently 
psychical  in  character. 

It  has  been  observed  that  with  individuals  of  so- 
called  "  peculiar  temperaments  "  accidents  slight  and 
insignificant  produce  many  and  diverse  untoward 
effects.  In  this  case,  the  excessive  pain  and  the 
emotional  shock  was  preceded  by  a  dissociation  pri- 
marily slight,  but  which,  by  a  systematization  devel- 
oped to  a  considerable  degree  of  extent  and  fixity. 
From  the  field  of  consciousness,  certain  normally  con- 
tributory psychomotor  systems  have  been  dissociated. 
These  systems,  dropping  to  the  subconscious,  produce 
psychomotor  disturbances. 

As  to  the  pre-existence  of  determining  subconscious 
memories,  nothing  further  than  a  suspicion  could  be 
maintained.  An  examination  clearly  revealed  the  fact 
that  the  patient's  subconscious  life  was  rather  highly 
developed  ;  patient  was  an  active  dreamer  and  a  som- 
nambulist. Of  the  sufficiency  of  affective  states  to 
produce  such  results,  a  number  of  cases  are  on  record. 

The  similarity  is  to  be  discovered  in  their  common 


The  Psychic  Trauma  263 

reference  to  one  cause — that  of  psychic  origin,  usually 
consisting  in  a  mental  dissociation  of  psychomotor 
states.  Of  the  many  cases  on  record,  we  take  a  few 
for  illustrating  our  point  of  view  : 

In  the  Journal de  Medecine  et  C/rirurgie,  Paris,  1895 
(pp.  888-890),  a  case  is  reported  in  which  the  con- 
tracture evidenced  was  traceable  to  a  slight  fall  and 
severe  mental  shock,  with  consequent  amnesia  for  a 
short  time.  The  contracture  noted  at  the  time  of  his 
later  attack  was  an  exact  reproduction  of  that  assumed 
at  the  time  of  the  psychic  trauma  causing  mental 
dissociation. 

Janet  reports  cases  in  which  contractures  regularly 
followed  dissociated  states  or  dreams.  In  one  case, 
for  instance,  the  patient  had  dreamed  vividly  of  play- 
ing the  piano,  compassing  octaves  rapidly.  The 
"  hands  became  contracted  in  the  position  a  pianist 
would  give  them  in  trying  to  stretch  an  octave."  In 
another  case,  the  contracture  assumed  was  presented 
by  a  young  woman  in  a  state  of  religious  ecstacy. 
The  rigidity,  sufficient  to  maintain  the  body,  is  a 
marked  psychomotor  manifestation  of  the  subcon- 
scious working  of  a  dissociated  system. 

In  another  case  a  young  man,  a  sailor  on  a  mer- 
chant-vessel, received  upon  the  chest  and  abdomen 
the  shock  of  a  barrel  rolling  on  the  deck.  He  was 
not  hurt,  but  he  remained  bent  forward  by  a  per- 
manent contracture  of  the  muscles  of  the  abdomen 
and  thorax. 


264  Psychopathological  Researches 

Fere  reports  a  case  of  paraplegia  following  a  dream. 
The  patient  dreamt  that  she  was  pursued  by  men, 
and  awoke  with  a  feeling  of  weakness  in  both  legs. 
For  two  weeks  in  succession  this  dream  kept  on  re- 
peating itself,  occurring  even  in  the  daytime,  finally 
developing  complete  paraplegia. 

An  interesting  case  is  reported  by  Dr.  Henry  L. 
Winter,  Associate  in  Anthropology  at  the  former 
Pathological  Institute  of  the  New  York  State  Hospi- 
tals. Since  the  case  is  closely  allied  in  character  to 
the  one  -presented  in  this  paper,  a  more  or  less  full 
account  of  it  is  given  here  : 

"  Edward  S.,  married,  aged  thirty-eight  years.  Born 
in  United  States  of  German  parents.  Occupation, 
barber. 

Family  history  :  Grandparents,  negative.  Mother 
died  of  apoplexy  during  confinement,  aged  thirty- 
eight  years.  This  was  the  second  attack.  First 
attack  three  years  previous.  Mother's  only  brother 
living  and  well,  but  of  very  emotional  nature.  Father, 
living  at  present,  aged  seventy  years,  suffers  from 
double  cataract.  Two  of  father's  brothers  became 
blind  at  about  same  ao-e  from  the  same  cause. 

Personal  history  was  negative  up  to  ten  years  of 
age.  The  death  of  his  mother  occurred  at  this  time 
and  was  announced  to  him  under  conditions  which 
excited  him  greatly.  He  became  mentally  depressed 
and  at  the  funeral  attempted  to  throw  himself  into 
his  mother's  grave.      From  that  time  he  has  continued 


The  Psychic  Trauma  265 

to  be  very  emotional,  and  at  present  laughs  and  cries 
without  provocation,  not  infrequently  laughing  when 
the  occasion  calls  for  serious  action.  These  emo- 
tional outbreaks  are  so  pronounced  as  to  interfere 
with  his  business  and  the  discipline  of  his  home.  At 
eleven  years  of  age,  the  patient  had  an  attack  of 
Bell's  palsy,  which  has  never  entirely  disappeared. 
He  has  had  no  other  illness  up  to  April,  1899.  At 
that  time  he  says  that  while  asleep  he  dreamed  that  he 
was  falling,  and  awoke  to  find  a  considerable  loss  of 
power  in  the  right  hand  and,  somewhat  less  marked, 
in  the  right  leg}  His  voice,  previously  firm  and  clear, 
became  weak  and  husky.  He  told  his  wife  that  he 
had  had  a  '  stroke.'  These  symptoms  continued  for 
about  two  months,  during  which  time  he  was  under 
treatment.  The  arm  recovered  first  and  then  the  leg. 
Patient  says  that  speech  never  became  perfectly  nor- 
mal. Patient  has  always  had  the  well-defined  idea 
that  he  would  die  of  paralysis,  and  the  same  idea  was 
apparently  held  by  other  members  of  his  family.  He 
had  been  bowling  considerably  about  the  time  the 
above  symptoms  appeared,  and  his  family  had  told 
him  to  stop  that  form  of  exercise  because  it  would 
lead  to  paralysis.  He,  himself,  ascribed  the  condi- 
tion to  excessive  bowling.  On  November  13,  1899, 
he  began  to  suffer  with  severe  occipital  headache, 
which  continued  for  several  days.  On  the  17th,  four 
days  after  the  onset  of  the  headache,  the  right  hand 

1  The  italics  are  mine. 


266  Psychopathological  Researches 

began  to  feel  numb  and  weak  and  the  headache 
ceased.  About  two  hours  later  the  voice  began  to 
diminish  in  volume,  and  after  the  lapse  of  about  two 
hours  more  the  leg  began  to  feel  'lifeless.' 

I  first  saw  the  patient  three  days  later,  November 
20,  1899.  At  that  time  there  was  a  right  hemiplegia 
with  almost  complete  aphonia.  The  paralysis  was 
more  marked  in  the  leg  than  in  the  arm.  Pressure 
on  the  dynamometer  registered  40  with  the  right 
hand  and  100  with  the  left.  The  superficial  and  deep 
reflexes  were  slightly  increased  on  the  right  side. 
The  muscles  were  slightly  spastic.  Irregular  spots 
of  partial  anaesthesia  were  present  on  the  dorsal  sur- 
face of  the  hand,  over  the  right  deltoid  muscle,  and 
on  the  right  side  of  the  face.  There  was  complete 
anaesthesia  about  the  mouth  on  both  sides.  Examina- 
tion of  the  throat  by  Professor  Coakley  revealed  a 
perfectly  healthy  larynx,  without  any  paralysis.  The 
emotional  condition  above  referred  to  was  very 
marked ;  patient  cried  during  entire  examination. 
Heart,  arteries,  and  kidneys  were  normal. 

The  history  and  condition  of  the  patient  were  sug- 
gestive of  a  psychical  origin  for  the  hemiplegia,  and  I 
decided  to  treat  him  on  that  basis.  I  gave  the  patient 
positive  assurance  of  speedy  recovery  and  advised 
him  that  the  leg  would  recover  first,  then  the  arm, 
and  finally  the  voice. 

On  November  27th  patient  reported  improved. 
The   paralysis    in    the    leg   was   greatly   diminished. 


The  Psychic  Trauma  267 

Dynamometer  registered  a  pressure  of  50  with  the 
right  hand  and  100  with  the  left.  Condition  of  voice 
unchanged.  Reflexes  still  slightly  increased  on  right 
side.  The  anaesthetic  spots  disappeared  from  the 
hand  and  diminished  in  size  over  shoulder,  but  re- 
mained the  same  on  the  face.  Patient  was  advised 
that  the  leg  would  be  entirely  free  from  paralysis 
when  he  next  returned,  and  that  the  arm  would  be 
greatly  improved  and  voice  stronger. 

December  4th  patient  again  reported.  The  paraly- 
sis had  entirely  disappeared  from  leg.  Dynamometer 
registered  a  pressure  of  65  with  the  right  hand  and 
105  with  the  left.  Reflexes  normal.  Condition  of 
voice  unchanged.  Anaesthetic  areas  had  disappeared 
from  shoulder  and  diminished  in  size  and  degree  on 
face.  Patient  advised  that  by  the  time  of  his  next 
visit  he  would  be  entirely  well. 

Patient  reported  on  December  nth.  At  this  time 
the  paralysis  in  arm  had  disappeared.  Dynamometer 
registered  no  right  and  100  left.  Reflexes  normal. 
The  aphonia,  however,  was  still  present.  The  ina- 
bility to  speak  above  a  whisper  did  not  appear  to  the 
patient  to  be  of  grave  consequence,  and  he  ceased 
treatment. 

On  December  12,  1900,  about  one  year  after  the 
occurrence  of  the  conditions  just  mentioned,  the  pa- 
tient came  into  my  office  dragging  the  right  leg  and 
with  the  right  arm  hanging.  He  could  not  speak 
above  a  very  low  whisper,  and  it  was  only  by  putting 


268  Psychopathological  Researches 

my  ear  close  to  his  mouth  that  I  could  hear  what  he 
said.  He  pronounced  the  words  properly,  but  seem- 
ingly with  great  effort.  He  said  that,  except  for  a 
weakness  in  his  voice,  he  had  been  perfectly  well  from 
the  time  I  had  last  seen  him  until  two  days  before. 
At  that  time  he  went  to  his  home,  after  bowling  for 
about  two  hours,  and  was  preparing  for  bed  when  he 
felt  dizzy.  He  sat  down  and  almost  immediately  lost 
consciousness.  This  lapse  of  consciousness  lasted  for 
about  five  (?)  minutes,  and  when  he  recovered  he 
could  not  move  his  arm  or  leg  nor  make  himself 
heard  when  he  tried  to  speak.  He  suffered  from  a 
slight  occipital  headache  and  soon  fell  into  a  deep 
sleep  which  lasted  all  night.  In  the  morning  he  felt 
well,  with  the  exception  of  the  paralysis. 

On  examination,  I  found  a  complete  right  hemi- 
plegia, including  the  face.  (At  the  first  attack  there 
was  no  paralysis  of  the  face  except  what  remained  of 
the  old  Bell's  palsy.)  The  muscles  were  in  a  spastic 
condition  and  the  lee  and  forearm  were  contracted. 
The  reflexes  were  only  slightly  increased.  The  vocal 
cords  and  larynx  were  not  examined.  The  entire 
right  side  of  the  face  was  anaesthetic,  but  there  were 
no  areas  of  anaesthesia  elsewhere. 

This  time  I  concluded,  if  possible,  to  decide  the 
nature  of  the  paralysis,  and  gained  the  patient's  con- 
sent to  induce  hypnosis.  I  made  him  no  promises 
beyond  stating  that  I  believed  the  treatment  would 
be  of  benefit  to  him.     During  the  first  three  days  I 


The  Psychic  Trauma  269 

was  unable  to  induce  anything  but  a  light  sleep,  fail- 
ing to  get  the  patient  to  respond  to  any  suggested 
movements.  At  the  fourth  trial,  however,  the  sleep 
was  considerably  deeper.  In  this  state  the  conditions 
remained  unchanged.  At  this  time  I  told  him  that  I 
was  going  to  apply  a  very  powerful  drug  to  his 
tongue,  after  which  he  could  speak  distinctly.  Tak- 
ing a  swab  of  cotton,  I  wet  it  with  warm  water  and 
applied  it  to  the  tip  of  the  tongue,  at  the  same  time 
asking,  '  How  do  you  feel  now?'  'Very  well,  thank 
you,'  the  patient  replied  in  a  moderately  strong  voice. 
I  then  told  him  that  I  was  oroinor  to  awaken  him,  and 
that  after  five  minutes  he  would  feel  that  his  tongue 
was  warm  and  would  speak  about  it,  his  voice  being 
strong  and  natural.  After  awaking  him  I  waited  six 
minutes,  and  then,  as  he  failed  to  speak,  asked  him  if 
everything  was  all  right.  He  shook  his  head,  but  said 
nothing,  and  after  waiting  a  moment  took  up  his  hat 
and  said  that  he  was  going-  home.  His  voice  was 
about  the  same  as  before  the  hypnosis. 

The  same  plan  was  pursued  on  the  following  day. 
About  five  minutes  after  I  had  awakened  him  he  sud- 
denly put  his  hand  up  and  touched  his  tongue,  at  the 
same  time  saying,  '  Doctor,  my  tongue  burns.'  His 
voice  was  loud  and  clear,  but  he  evidently  did  not  no- 
tice this  fact,  because  when  I  said,  '  Why,  your  speech  is 
all  right  now,'  he  began  to  deny  it,  but  was  convinced 
by  the  continuation  of  its  full  volume,  and  became 
greatly  excited.     After  the  excitement  had  subsided 


270  Psychopathological  Researches 

I  examined  him  and  found  that  the  paralysis  of  the 
face  had  also  disappeared  (except,  of  course,  the  re- 
mains of  the  old  Bell's  palsy).  The  patient  conversed 
with  me  for  several  minutes,  the  voice  retaining  its 
strength  and  fulness. 

On  the  next  day  the  voice  still  continued  strong, 
and  has  remained  so  to  date  (June,  1901).  The  par- 
alysis of  the  face  had  not  returned.  Patient  was  again 
hypnotized  and  asked  if  he  could  walk  without  drag- 
ging his  feet.  He  replied  that  he  could  not.  '  Yes, 
you  can,'  I  replied.  '  Try  it ! '  He  refused  to  try, 
and  I  again  ordered  him  to  walk.  This  time  he 
stepped,  but  dragged  his  leg.  The  command  was  re- 
peated. He  hesitated  for  a  moment  and  then  walked 
normally.  I  asked  him  what  was  the  trouble  with  his 
arm,  and  he  replied  that  it  was  paralyzed.  I  told  him 
that  it  was  not,  and  ordered  him  to  put  it  out.  He 
tried,  but  apparently  could  not ;  then  tried  again  with 
greater  success.  I  urged  him  to  put  it  out  straight, 
and  he  complied  without  hesitation.  I  placed  the 
dynamometer  in  his  hand  and  commanded  him  to 
press  it,  which  he  did,  registering  100.  After  making 
him  exercise  the  arm  in  various  ways,  I  told  him  that 
the  paralysis  was  all  gone,  and  that  it  would  never 
trouble  him  after  he  woke  up.  Then  seating  him,  I 
told  him  to  open  his  eyes.  For  a  few  minutes  he  sat 
watching  me  while  I  wrote,  and  then,  apparently  for- 
getful of  the  former  paralysis,  reached  out  his  right 
hand  and  took  his  hat  from  the  table.      I  then  bade 


The  Psychic  Trauma  271 

him  good-morning,  and  he  left  without  making  any 
reference  to  his  condition. 

The  next  morning  he  returned  accompanied  by  his 
wife,  who  said  that  while  he  had  used  his  arm  and  leg 
well  he  had  been  stupid  and  dull  since  he  arrived  at 
home  the  preceding  day,  and  had  failed  to  take  any 
interest  in  things  which  ordinarily  appealed  to  him. 
Patient  appeared  still  to  be  partially  under  hypnotic 
influence,  and  I  accordingly  rehypnotized  him,  and 
after  repeating  the  same  commands  as  on  the  previous 
day,  I  told  him  that  he  would  be  wide  awake  as  soon 
as  I  touched  his  eyes  and  told  him  to  open  them. 
After  I  had  done  this,  the  patient  remained  seated  for 
a  moment,  and  then  jumped  up  and  began  walking  up 
and  down  the  room  considerably  excited.  I  spoke  to 
him,  and  he  immediately  controlled  himself  and  sat 
down  and  talked  rationally.  There  was  absolutely 
no- paralysis  (except,  again,  the  remains  of  the  Bell's 
palsy),  and  the  voice  and  speech  were  perfectly 
normal. 

The  patient  reported  to  me  from  time  to  time  up 
to  May  1,  1 901,  when  he  left  town.  There  has  been 
no  return  of  the  trouble,  but  the  emotional  disturb- 
ances still  occur,  though  not  so  frequently." 

Characteristic  tremor-tracings  under  conditions  of 
fatigue  taken  of  this  case  by  Dr.  Sidis  in  the  Psycho- 
pathological  Laboratory  are  interesting  from  the 
standpoint  of  the  relation  of  neuron  energy  and  fatigue 
to  various  states  of  dissociation,  with  their  underlying 


272  Psychopathological  Researches 

conditions  of  neuron-disaggregation  and  neuron  de- 
generation. Along  with  other  experiments  and 
tracings  they  will  be  published  in  a  special  paper. 

Dr.  Winter  goes  on  to  say  :  "  Several  theories  have 
been  advanced,  the  most  widely  known  of  which  is 
probably  that  of  the  Nancy  School.  The  concep- 
tions of  Bernheim  do  not,  however,  appear  to  ex- 
plain the  various  conditions  with  which  we  come  in 
contact  clinically.  My  own  views  are  based  upon  the 
theories  advanced  by  Sidis." !  We  agree  on  this  point, 
but  as  the  more  theoretical  aspect  of  the  phenomena 
under  investigation  is  relegated  to  another  place,  we 
omit  Dr.  Winter's  discussion.  What  is  specially  in- 
teresting in  the  case  is  the  close  similarity  of  type 
with  the  one  presented  here.  There  is  a  history  of 
patho-psychosis,  of  a  high  degree  of  emotionalism 
and  suggestibility,  a  tendency  towards  psychopathic 
dissociations  caused  by  the  death  of  patient's  mother, 
the  presence  of  a  psychic  trauma  subconsciously  ex- 
perienced in  a  vivid  dream  and  giving  rise  to  psycho- 
motor disturbances,  to  loss  of  kinesthetic  sensations 
and  memories  in  waking  life.  From  this  standpoint 
we  can  realize  the  paramount  importance  of  the  ac- 
count elicited  from  the  patient,  that  "  while  asleep 
he  dreamed  that  he  was  falling,  and  awoke  to  find 
a  considerable  loss  of  power  in  the  right  hand  and 
somewhat  less  marked  in  the  right  leg." 

The  reverse  process,  however,  may  happen  :    In- 

1  The  Medical  Neivs,  New  York,  January  4,  1902. 


The  Psychic  Trauma  273 

stead  of  taking  place  subconsciously  the  psychic 
trauma  occurs  in  waking  life,  the  dissociated  system 
sinks  into  the  obscure,  dreamy,  subwaking  region  of 
the  subconscious,  and  from  thence  causes  psychomotor 
disturbances  in  the  normal  waking  state.  Such  was 
the  course  of  the  process  in  the  present  case.  From 
whichever  region,  however,  whether  waking  or  sub- 
waking, the  psychopathic  process  may  start,  the  out- 
come is  the  same, — the  psychomotor  disturbances  are 

due  to  persistent  dissociated  subconscious  systems. 

18 


CHAPTER  III 

DISSOCIATION    AND    SYNTHESIS 

To  return  then  to  our  case  :  what  remains  to  be  con- 
sidered is  the  further  development  of  these  complex 
series  of  dissociation,  based  upon  the  established 
genetic  point.  By  reason  of  the  dissociation  which 
has  evidently  occurred  in  this  case,  a  certain  system 
became  subconscious ;  its  very  intensity  served  to 
accentuate  and  make  it  dominant. 

With  a  system  of  such  freshness  and  intensity,  the 
tendency  was  rather  towards  extension  than  even 
relative  fixity.  The  application  of  the  straps  to  the 
foot,  a  necessary  measure,  was  here  another  of  the 
causative  factors.  The  resultant  prevention  of  move- 
ment produced  a  deeper  lapse  of  kinesthetic  sensa- 
tions and  memories  relative  to  the  particular  affected 
member.  The  growth  and  development  of  the  dis- 
sociated system  progressed,  aided  by  the  very 
failures  of  attempts  at  its  disintegration.  It  will  be 
recalled  that,  three  weeks  after  the  accident,  patient 
removed  straps  and  unsuccessfully  attempted  to  walk. 
That  success,  which  would  have  disintegrated  the 
previously  constructed  system,  here  was  wanting. 
This  plainly  signified  that  thus  early  was  the  system- 
atization  compact  and  strong.     Crutches  now  were 

274 


Dissociation  and  Synthesis  275 

ordered.  During  all  this  time,  the  sympathy  shown 
by  the  family,  appreciably  aided  the  result.  After  six 
months,  the  patient  was  taken  to  several  surgeons. 
Unwisely,  also,  series  of  suggestive  questions,  were 
offered  to  the  now  sensitive  mind  of  the  patient. 
Following  one  of  these  consultations  there  began  to 
develop  a  rather  novel  extension  of  this  system. 
Over  all  bony  surfaces  hyperesthesia  soon  pre- 
vailed. Its  source  was  readily  traced  to  the  marked 
attention  directed  by  the  surgeon  to  these  identical 
points.  So  marked  was  this  development  that  one 
year  later  it  presented  itself  as  one  of  the  promi- 
nent aspects  of  the  case.  The  dependence  of  the 
oedema  upon  the  systematization  was  evident.  The 
oedema  did  not  appreciably  develop  until  six  months 
after  accident.  At  this  time,  it  appeared  in  a  slight 
degree,  as  a  consequence  of  the  continuous  applica- 
tion of  straps  and  suspension  of  leg.  Its  appearance 
was  duly  noted  by  consultants,  and  the  dissociated 
system  thereby  correspondingly  nourished.  At  least, 
we  know  that  about  this  time  an  increase  became 
apparent,  accompanied  by  pain,  later  by  discoloration. 
That  aberrations  of  vasomotor  control  form  promi- 
nent features  of  so-called  "  hysterical "  syndromes 
countless  citations  would  confirm.  In  the  present 
case,  a  grasping  powerful  subconscious  system  un- 
doubtedly aided  in  the  result.  The  slight  pain, 
primarily  produced  by  stasis,  further  increased  the 
assimilating  power  of  the  dissociated  system. 


276  Psychopathological  Researches 

At  the  hospital  was  enacted  the  last  act  in  the 
production  of  an  absolutely  functionless  joint.  The 
application  of  a  plaster  cast,  the  marked  elevation  of 
the  foot,  were  the  finishing  details.  Repeated  exami- 
nations, with  and  without  anaesthesia,  availed  nothing. 
The  examination,  however,  confirmed  the  surgical 
opinion,  that  further  care  in  the  hospital  was  use- 
less. The  obstinacy  of  the  family,  however,  delayed 
the  patient's  discharge,  until  six  months  later.  The 
description  of  the  joint,  at  this  time,  has  previously 
been  given. 

In  the  study  of  the  case,  much  was  left  undone  that 
should  have  been  done.  The  reluctance  of  the  fam- 
ily towards  the  use  of  psychopathic  methods  pre- 
vented a  clear  analysis  of  the  genesis.  The  failure 
to  utilize  these  measures  undoubtedly  extended  the 
time  limits  of  the  subsequent  treatment.  What  was 
necessary  here  was  the  recovery  of  the  normal  func- 
tions, by  synthethising  the  dissociated  systems  into 
the  patient's  personal  consciousness. 

The  groups  which  had  most  probably  lapsed  in  the 
functioning  of  the  joint  were  the  kinesthetic  sensa- 
tions and  memories.  Towards  their  recovery  our 
efforts  were  first  directed,  as  it  was  evident  that  their 
function  was  especially  affected  and  formed  the 
nucleus  of  the  dissociated  system. 

With  both  feet  before  her,  the  patient  was  told  to 
close  her  eyes,  then  to  flex  and  extend  both  ankles. 
The  normal  only  responded.     Then  she  was  told  to 


Dissociation  and  Synthesis  277 

especially  note  and  intently  think  how  the  ankle  felt 
when  moved.  During  this  time  my  position  was  di- 
rectly behind  patient.  When  the  normal  joint  was 
fully  flexed,  she  was  suddenly  commanded  to  flex  the 
(left)  invalided  joint.  There  was  an  increased  re- 
sponse. 

Taking,  then,  a  small  dry-cell  battery  of  weak  po- 
tentiality, an  application  was  made  to  the  left  ankle, 
with  insistence  upon  reproduction  of  sensation  of 
flexion.  At  first  only  the  toes  moved,  but  with  in- 
creased and  unremitting  insistence  there  suddenly  oc- 
curred a  more  or  less  complete  normal  flexion.  The 
patient  saw  it,  but  insisted  she  did  not  feel  it,  attribu- 
ting it  to  the  battery,  which  at  that  particular  moment 
was  not  applied.  As  illustrative  of  the  strength,  com- 
pactness, and  resistance  of  the  system,  it  need  only 
be  added  that  not  for  three  months  did  so  complete  a 
flexion  again  occur.  The  utmost  endeavors, — under 
the  limited  conditions  set  by  the  family  were  insuffi- 
cient to  reproduce  this  almost  initial  result.  Had  other 
methods  been  employed  at  this  time,  the  termination 
of  the  case  might  have  been  greatly  hastened.  That 
which  did  date  from  this  period  was  the  gradual  restora- 
tion of  the  psychomotor  function.  A  certain  degree  of 
flexion  was  soon  induced  ;  later,  in  three  weeks,  freer 
locomotion.  The  oedema  was  similarly  handled.  The 
removal  of  the  supports,  the  immediate  lowering  of 
the  foot  coincident  with  the  tepid  douche  of  the 
spine,  of  itself  non-remedial,  but  in  conjunction  with 


278  Psychopathological  Researches 

suggestion  speedily  removed  the  oedema.  The  main- 
tenance of  a  normal  vasomotor  control  was  further 
conditioned  by  the  recovery  of  the  lost  kinesthetic 
elements. 

In  order  satisfactorily  to  accomplish  a  complete 
functional  restitution,  a  maintenance  of  definite  con- 
ditions is  a  distinct  necessity.  Intelligent  directions 
must  be  given,  so  that  the  patient  may  not  undo  all 
that  has  been  done.  To  the  interference  with  such 
directions  may  partially  be  ascribed  the  duration  of 
the  case  for  six  months,  rather  than  for  six  weeks. 
That  the  recovery  or  synthesis  of  dissociated  ele- 
ments has  not  been  completed  has  been  demonstrated 
by  the  occurrence  of  contractures  in  other  joints  for 
short  periods  of  time.  Until  the  synthesis  is  com- 
plete, such  recurrences  must  be  foreseen. 

Association  in  this  case  has  not  been  fully  effected. 
The  oedema  disappeared.  The  joint  has  attained  a 
fair  degree  of  function.  The  angle  of  motion  is  some- 
what less  than  normal.  Locomotion  is  easy,  free, 
though  not  entirely  perfect. 

Cases  as  the  one  described  here  are  by  no  means 
rare.  What  is  specially  interesting  from  the  psycho- 
pathological  standpoint  is  the  common  typical  traits 
presented  by  all  of  them,  namely,  kinaesthetic  anaes- 
thesia and  loss  of  motor  memories.  As  pointed  out 
by  Dr.  Sidis  in  a  previous  paper,  sensori-motor  and 
ideo-motor  groups,  though  normally  more  persistent, 
on  account  of  the  wealth  of  associations  which  they 


Dissociation  and  Synthesis  279 

readily  form,  are  for  that  very  reason  also  more  sub- 
ject to  derangements,  to  dissociations.  In  the  process 
of  mental  dissolution,  motor  memories  are  the  first  to 
become  affected} 

1  See  pp.  197,  198,  199. 


Mental   Dissociation 

In 
Psychomotor  Epilepsy 

By 

George  M.   Parker 


CHAPTER  I 

PSYCHOMOTOR    MANIFESTATIONS 

The  patient  is  a  German,  thirty-three  years  of  age  ; 
single.  He  has  followed  the  seas  for  many  years,  in 
both  the  navy  and  the  merchant  arm  of  the  service, 
chiefly  in  the  capacity  of  fireman.  Of  his  family,  he 
can  give  but  little  information.  His  mother  was  a 
woman  of  violent  temper  ;  her  rages  have  been  marked 
by  great  excess  and  chronicity  ;  of  his  father,  he  knows 
no  facts  of  interest  or  importance.  The  status  and 
education  of  both  parents  were  ordinary.  The  mem- 
ories of  his  childhood  are  rather  scanty.  His  educa- 
tion was  no  more  than  that  of  the  routine  German 
common  school. 

He  was  fairly  interested  and  advanced  in  his  work. 

280 


Psychomotor  Manifestations  281 

There  is  no  evidence  of  neurosis  in  his  early  history. 
Of  the  diseases  of  infancy  nothing  can  be  obtained.  In 
his  childhood  he  had  measles  and  pertussis,  neither  of 
which  was  followed  by  any  grave  sequelae.  His  later 
history,  although  more  varied,  is  equally  uneventful. 

His  life  as  a  seaman  has  subjected  him  to  some- 
what severe  experiences.  He  has  undoubtedly  suf- 
fered numerous  traumas.  None  of  these,  however, 
have  invalided  him  to  any  extent.  He  has  never  con- 
tracted any  specific  troubles.  He  is  moderate  in  his 
drink.  The  patient  has  had  two  severe  fevers,  from 
both  of  which  he  made  a  complete  recovery.  Later 
he  continued  his  service  in  the  navy.  Three  years 
ago,  while  upon  shore  duty,  he  became  interested  in  a 
young  girl  who  resided  at  his  boarding-house  ;  to  her 
he  represented  himself  as  younger  than  his  papers 
showed.  The  landlady  quietly  informed  the  young 
lady  of  this  deception  ;  a  mutual  upbraiding  followed, 
and  the  girl  deserted  the  patient.  The  distress  of  the 
patient  induced  him  to  drink,  and  for  three  days 
nothing  but  whiskey  was  taken. 

At  the  expiration  of  this  period  his  condition  was 
weak  and  overstrung.  On  the  evening  of  the  third 
day  of  this  debauch,  he  entered  the  front  door  of  the 
boarding-house,  walked  through  the  saloon,  past  the 
lunch  bar,  into  the  kitchen  where  he  found  the  land- 
lady. Towards  her  the  patient  directed  his  invective, 
as  being  the  source  of  all  his  evil.  As  he  was  talk- 
ing,  suddenly  his  hands  were  extended,  and  he  fell. 


282 


Psychopathological  Researches 


He  awoke  in  a  dark  room  off  the  kitchen,  and  was 
told  that  he  had  been  "sick."  He  could  remember 
nothing  beyond  having  talked  to  the  woman,  feeling 
weak,  and  falling.  There  was  some  stupor  following 
the  attack.  There  was  no  aura, — no  sensations,  gen- 
eral or  particular, — preceding  this  attack. 

Since  this  time,  he  has  had  numerous  attacks  at 
varied  intervals.  In  the  beginning,  the  attacks  oc- 
curred but  once  in  two  or  four  weeks  ;  the  interval 
gradually  declined  until,  for  the  last  six  months  pre- 
vious to  treatment,  the  attacks  were  manifested  three 
or  four  times  per  week ;  at  the  latter  end,  once  or 
twice  per  day.  Preceding  all  attacks  subsequent  to 
the  primary,  there  has  been  a  feeling  of  pain  and 
distress  over  the  epigastrium ;  it  proceeded  upward, 
and  was  immediately  succeeded  by  an  attack.  In 
these  attacks  he  has  usually  fallen,  lying  quietly  out- 
stretched, with  fingers  clutched ;  sometimes  he  is 
restless,  his  hands  fumbling  aimlessly.  At  times  he 
has  had  general  motor  disturbances,  his  arms  and 
legs  twitching,  frothing  at  the  mouth.  Again,  oc- 
casionally he  did  not  fall,  but  sat  upon  a  chair,  staring 
fixedly  before  him.  Any  degree  of  excitement  suf- 
ficed to  initiate  an  attack.  Card-playing  alterca- 
tions have  invariably  produced  attacks.  There  has 
been  complete  amnesia  succeeding  all  attacks. 
His  stupor  following  has  also  been  an  unvarying 
feature.  The  change  in  his  mental  attitude  has 
been  very  noticeable.     He  has  become  progressively 


Psychomotor  Manifestations  283 

less  able  to  attend  to  his  duties ;  constantly  forgets ; 
fails  frequently  to  comprehend  remarks  or  orders 
given  to  him.  His  memory  as  to  the  past  ante- 
dating his  attacks  has  been  weakened.  He  has 
described  himself  as  being  in  a  state  of  constant  con- 
fusion. His  depression  and  so-called  stupidity  have 
been  very  evident.  He  has  secluded  himself  ;  has 
become  unsocial,  brooding,  irritable.  He  has  evinced 
but  little  interest  for  his  friends  or  occupation.  His 
sleep  has  become  light ;  his  dreams  distressing. 
Upon  awaking,  his  depression  is  exceedingly  acute. 
His  somatic  condition  has  been  lowered;  he  is  far 
below  weight ;  his  hands  have  become  tremulous  ; 
his  gait  is  uncertain. 


CHAPTER   II 

FIRST    ATTACKS    AND    AURA 

With  this  history  the  patient  presented  himself  on 
the  14th  of  October,  1901.  A  history  like  this  is 
without  any  hesitation  regarded  as  epilepsy,  and  in 
fact  the  physician  who  treated  the  patient  pronounced 
the  case  as  that  of  typical  epilepsy,  with  petit  mat 
attacks  as  the  predominating  "symptoms."  Let  us 
see  what  a  closer  scrutiny  revealed.  There  were  cer- 
tain features  about  the  case  which  did  not  seem  to  in- 
dicate epilepsy.  There  was  the  absence  of  any  aura 
at  the  initial  attack,  with  later  an  appearance  of  a  very 
definite  aura  at  succeeding  attacks.  Further,  the 
patient  now  and  again  could  give  a  stray  memory 
from  one  of  the  attacks.  This  aroused  our  suspicions. 
The  definiteness  of  the  flash  of  recovered  fragments  of 
memory  did  not  quite  resemble  the  mental  condition 
of  the  attacks  of  typical  organic  epilepsy.  Should  he 
now  be  able  to  give  a  full  account  of  experiences 
during  one  of  his  attacks,  his  condition  would  still 
less  resemble  organic  epilepsy.  If  memory  of  one 
attack  could  be  regained,  the  entire  series  might  well 
be  recoverable.  This  would  definitely  prove  a  func- 
tional   psychosis,    a   psychosis   simulating  epilepsy.1 

'See  introduction,  also  pp.  199,  212,  218. 
284 


First  Attacks  and  Aura  285 

With  these  possibilities  in  view,  on  the  2  2d  of  Oc- 
tober, one  week  after  initial  examination  of  the 
patient,  systematic  work  was  begun.  The  patient 
was  deeply  hypnotized.  During  this  condition  there 
was  a  strong  insistence  upon  his  recalling  all  the 
incidents  of  his  first  attack. 

The  patient  was  profoundly  affected.  He  spoke  at 
first  hesitatingly,  with  some  motor  disturbances,  his 
hands  twitching.  He  was  very  restless  until  he  had 
begun  ;  after  this  but  little  assistance  was  needed. 
He  said  :  "  I  was  standing  in  the  kitchen,  talking  with 
the  landlady,  when  I  felt  weak  and  fell." — "  No,  I  was 
not  dizzy,  simply  weak."  He  was  asked,  "  What  were 
you  thinking  of?"  He  answered,  "  Of  the  girl."  He 
was  asked,  "  Did  you  fall  to  make  the  landlady  feel 
badly?"  He  answered:  "No,  I  fell  because  I  was 
weak.  Then,  when  I  fell,  the  missus  called  to  her 
man,  and  he  came  and  picked  me  up."  When  asked, 
"  How?"  he  said  :  "  By  the  shoulders.  The  woman 
said,  '  William  is  sick.'  I  remember  it  all  now.  Then 
they  carried  me  to  a  little  dark  room  and  laid  me 
down,  and  I  asked  where  I  was  and  why  they  do  that. 
Then  the  girl  she  came  in  and  asked  me,  '  Billy,  what 
is  the  matter?'  and  I  told  her,  '  Nothin',  everything 
is  all  right'  Then  she  asked  if  it  is  her  fault,  and  I 
said,  '  No,'  it  has  nothing  to  do  with  you.  Then  the 
missus  say  to  her,  '  You  go  away  now,'  and  the  girl 
goes  away  crying.  Then  I  wake  up  and  ask  all  about 
it,  but  they  tell  me  nothing,  except  that  I  was  sick." 


286         Psychopathological  Researches 

Interruptions  in  the  form  of  questions  retarded 
and  troubled  him,  thereby  causing  a  mild  excitement. 
A  short  rest  was  given,  during  which  the  patient 
sank  to  the  former  depth  of  hypnosis,  from  which 
he  had  partially  risen  during  the  revival  of  these 
memories. 

A  description  of  the  next  attack  was  entered  upon. 
There  was  hesitancy  at  first,  soon  followed  by  great 
ease  and  facility  of  reproduction.  He  said  :  "  I  was 
standing  in  front  of  the  house,  talking  with  a  fellow, 
in  the  evening,  when  I  suddenly  get  dizzy  and  fall. 
As  I  lie  on  the  ground,  I  remember  now  seeing  him 
run  to  the  house  for  the  boss,  saying,  '  Come  out, 
William  is  sick.'  Other  people  were  there.  Yes,  I 
remember  them  now.  They  were  from  the  same 
house,  and  they  all  looked  frightened  and  asked  what 
was  the  matter  with  me.  I  remember  the  boss  com- 
ing out  with  the  men  and  putting  me  in  a  chair,  and 
then  I  woke  up." 

He  was  awakened  gradually  and  slowly.  When 
asked,  if  he  now  remembered  about  his  first  attack,  he 
assumed  an  attitude  and  expression  of  extreme  ab- 
straction. In  this  condition,  with  great  detail,  he  re- 
lated all  the  incidents  previously  given.  The  emerged 
memories  were  very  vivid.  "  I  see  them  out  of  my 
own  head,"  he  said.  "  I  see  the  people,  the  street ; 
God  !  I  see  it  all.  It  is  not  like  some  one  telling  me  ; 
it  is  like  seeing  it  yourself.      I  remember  it  all  now." 

We  have  here  seen  that  the  memories  of  the  first 


First  Attacks  and  Aura  287 

two  attacks  were  fully  recovered.  If  now  we  could  trace 
the  genesis  of  the  aura  and  the  content  of  experiences 
of  the  psychomotor  attacks,  the  functional  character 
of  the  epilepsy  could  be  clearly  demonstrated. 

During  the  latter  course  of  the  previous  conversa- 
tion, the  patient  voluntarily  stated  that  he  had  just 
recalled  that,  beginning  with  his  second  attack  the 
seizures  had  been  preceded  not  only  by  a  stomach 
pain,  but  also  by  an  immediately  succeeding  foul  taste 
in  his  mouth,  accompanied  by  a  most  fetid  odor. 

A  sense  of  nausea  overlaid  all.  Particularly,  it  is 
to  be  noted,  that  this  aura  appeared  at  the  second  at- 
tack. This  would  seem  to  refer  the  time  of  its  genesis 
to  that  of  the  initiatory  attack  ;  yet  nothing  that  could 
be  elicited  from  the  patient  in  his  waking  state  seemed 
to  strengthen  the  supposition.  At  the  time  he  fell  in 
the  kitchen,  dinner  was  being  prepared.  The  smell 
was  like  nothing  there.  To  him  the  smell  resembled 
that  arising  from  the  floor  of  the  fire-room  in  a 
steamboat  upon  which  has  escaped  the  surplus  oil, 
remaining  there  until  it  has  become  rancid.  Were 
this,  however,  the  true  genesis,  then  the  first  attack 
should  have  been  so  conditioned  equally  with  those 
succeeding.  Again,  it  will  be  recalled  that  the  patient 
had  been  seriously  ill  with  both  yellow  and  malarial 
fevers,  with  general  delirium.  No  medicine  taken  at 
the  time,  no  odor  of  the  hospital,  nor  of  the  forecastle 
resembled  that  of  the  aura.  Moreover,  the  same  ob- 
jection can  be  made  against  this  supposition  as  against 


288  Psychopathological  Researches 

the  immediately  preceding  one, — the  aura  should 
have  then  been  present  at  the  first  attack.  It  was 
evident  that  nothing  further  could  be  gained  in  the 
waking  state.  It  remained  only  to  tap  the  subcon- 
scious. Hypnosis  was  easy,  as  usual.  An  immediate 
search  after  the  origin  of  the  aura  followed. 

There  was  first  an  insistence  upon  the  patient's 
recollecting  the  taste  and  the  smell  constituting  the 
aura,  as  to  how  they  came.  With  but  slight  hesita- 
tion the  patient  said,  "  It  was  a  bad  taste,  like  the 
taste  of  bad  meat."  When  asked,  if  it  was  like  the 
smell  of  bad  meat  cooking,  he  said  :  "  No,  it  was 
like  the  bad  meat — the  same  bad  meat  that  I  take 
from  the  bar  and  eat  as  I  go  through  the  kitchen, 
when  I  go  to  talk  to  the  missus,  just  a  moment  before 
I  have  my  attack.  I  had  it  in  my  mouth  when  I  fell. 
I  remember  it  all  now." 

It  will  be  seen  that  thus  readily  we  have  traced 
the  genesis  of  the  aura  and  psychomotor  attack  to  a 
previous  dissociated  psychic  experience  with  which 
subconscious  states  became  accidentally  associated 
through  the  intense  unpleasant  affective  tone.  This 
experience  occurred  at  the  time  of  his  first  attack. 
The  appearance  of  a  definite  aura  only  at  the  second 
and  all  succeeding  attacks  is  hence  explained. 

Upon  emerging  from  hypnosis  all  previously  given 
details  were  retained  by  the  patient.  This  particular 
memory,  initially  dissociated,  had  been  recovered. 
The  recovery  and  reassociation  or  synthesis  of  these 


First  Attacks  and  Aura  289 

dissociated  memories,  with  the  method  employed  for 
so  doing,  will  be  exemplified  in  details  to  follow. 

On  the  evening  of  this  same  day  on  which  we  found 
the  origin  of  the  aura  the  patient  had  a  light  attack 
while  at  dinner.  He  recalled  putting  his  knife  and 
fork  upon  the  table,  staring  absently  in  front  of  him. 
He  forgot  all  subsequent  occurrences  until  some  one 
grasped  his  arms,  at  which  he  awakened.  There  was 
no  aura.  This  attack,  however,  had  been  unusually 
light.  Further,  after  his  emergence,  he  was  aware  that 
he  had  experienced  it.  Upon  the  day  previous  a  simi- 
lar attack  had  occurred,  this  time,  however,  without 
absolute  amnesia.  Within  a  few  moments  after  the 
occurrence  he  had  recalled  all  that  had  happened. 

His  appearance  began  to  improve.  He  was  brighter 
and  less  tardy  in  responding.  He  states  that  he  re- 
members more  accurately ;  his  head  feels  clearer. 
His  sleep  is  easier  and  less  disturbed.  It  is  to  be 
noted  that  although  he  recalls  all  the  reassociated 
attacks,  beyond  this  he  cannot  go. 

The  first  attack  has  been  fully  verified  by  the  pro- 
prietor of  the  house.  The  latter  has  described  the 
patient's  falling  down,  remaining  stretched  out  upon 
the  floor,  unable  to  be  roused,  later  being  carried 
to  the  dark  room,  where  the  girl  came  in  and  spoke  to 
the  patient,  then  left ;  of  his  remaining  in  this  state 
for  half  an  hour  ;  of  his  finally  emerging,  being  some- 
what stupefied,  and  recalling  none  of  the  particulars 
of  the  attack,  everything  being  a  blank  to  him. 


CHAPTER    III 

SUBMERGED    EXPERIENCES    OF    LAPSED    PERIODS 

Upon  the  28th  he  was  again  hypnotized.  At  this 
time  the  following  lapsed  periods  emerged  :  "  It  was 
in  the  back  room  upstairs  ;  we  had  a  pint  of  beer  and 
were  playing  cards,  and  I  had  only  one  glass,  when 
I  fell  down.  Then  the  woman  she  says,  '  What  is  the 
matter  with  William?'  and  her  husband  he  say, 
'  Nothing  is  the  matter.  He  will  be  all  right.  It  is 
just  as  he  had  it  downstairs.'  But  she  was  afraid, 
and  then  they  carried  me  to  the  bed.  No,  a  man 
came  in  and  helped  the  other  man,  and  he  took  me 
around  the  waist  and  laid  me  on  the  bed,  and  I  looked 
around,  but  I  did  n't  say  anything,  and  then  I  went  to 
sleep.  Yes,  I  remember  it  all.  There  was  the  same 
bad  taste  in  my  mouth  and  throat,  just  like  the  bad 
meat ;  the  same  bad  taste  that  I  had  in  the  bar-room 
just  before  the  time  I  fall  down  first." 

After  a  short  interval  the  next  attack  was  attempted. 
With  greater  ease  and  facility  he  proceeded  : 

"It  was  on  the  St.  Louis,  in  the  fire-room.     I  was 

drawing  fire,  when  I  feel  that  bad  taste  in  my  mouth 

like  rotten  meat,  and  I  go  for  a  drink  of  water,  and  I 

fall.     A  man  takes  hold  of  my  arm  and  drags  me  to 

290 


Submerged  Experiences  291 

the  hall,  and  they  ask,  '  What  is  the  matter  ?'  and  then 
they  leave  me  and  go  away.  I  saw  a  trimmer,  and  he 
asked  them,  '  What  is  the  matter  ? '  After  that  I 
climbed  up  the  ladder  to  the  deck,  and  came  back 
without  seeing  any  one,  and  go  to  the  fire-room,  and 
they  ask  me  how  I  was  and  I  say  '  All  right,'  and  then 
I  wake  up." 

After  his  awakening,  the  patient  apparently  ampli- 
fies the  account  given  during  hypnosis.  By  careful 
comparison,  however,  it  was  found  that  the  amplifi- 
cation did  not  hold  as  regards  the  memories  brought 
out  during  hypnosis.  It  was  effective  only  for  those 
memories  immediately  preceding  and  following  the 
attack,  which  had  particularly  suffered  by  reason  of 
the  dissociation,  but  which  themselves  had  not  been 
dissociated,  or  if  so,  but  very  slightly.  Such  states 
would  ordinarily  be  regarded  as  epileptic  "psychic 
equivalents."  As  a  matter  of  fact,  the  very  motor  at- 
tacks were  not  of  an  epileptic  nature,  but  of  the  char- 
acter of  functional  psychosis. 

The  next  revival  of  lapsed  content  was  attempted 
on  the  30th. 

At  this  time,  in  hypnosis,  the  patient  said  :  "It  was 
in  Harlem  River  Park  ;  yes,  it  was  after  I  came  back 
on  the  steamboat.  I  was  sitting  at  the  table  with  a 
girl — not  my  old  girl, — and  then  the  bad  taste  come 
in  my  mouth,  and  I  get  up  and  say,  '  I  go  to  walk  in 
the  garden.'  Then  I  walk  up  and  down  the  garden. 
No,  I  see  no  one  I  know.     They  did  not  look  at  me 


292  Psychopathological  Researches 

much,  but  make  way  for  me,  and  I  think  about  the 
girl  and  how  I  can  leave  her.  Yes,  the  table  was  on 
one  side,  and  I  walk  all  around,  and  when  I  wake  up 
I  was  in  the  middle  of  the  garden,  near  the  bar.  No, 
I  had  not  drank  much  beer,  only  one  glass.  The  girl 
was  not  my  first  girl.  I  remember  it  all  now."  This 
woman  has  been  seen,  and  has  given  a  statement  sup- 
porting in  full  the  patient's  account.  Being  the  first 
attack  which  she  had  ever  witnessed,  it  was  particu- 
larly striking.  She  described  his  appearance,  the  fix- 
ity and  blankness  of  his  eyes,  his  sudden  departure, 
his  walking  up  and  down  the  garden.  When  he  came 
back  to  her  and  sat  down  he  did  not  know  that  he 
had  left  her,  could  recall  nothing  as  regards  it,  and  was 
greatly  frightened.      He  had  had  but  one  glass  of  beer. 

After  awakening  from  his  hypnotic  state,  there  was 
the  usual  recapitulation  with  customary  detail  and 
vividness.  The  patient  said  :  "  When  I  came  back  to 
the  girl  she  asked  where  I  had  been,  and  I  said,  '  Right 
here,'  and  then  she  told  me,  and  I  told  her  not  to  let 
me  do  that  again."  This  last  memory  emerged  in  the 
post-hypnotic  state.  It  is,  however,  probable  that  the 
patient  woke  up  in  the  garden,  and  that  the  time  in- 
tervening between  this  awakening  and  the  point  at 
which  he  found  himself  beside  the  girl  had  been 
slightly  dissociated,  the  patient  still  having  been  in  a 
state  of  confusion. 

A  few  days  later,  the  patient  reported  having  had 
two  attacks.     In  the  first,  he  was  standing  at  the  lunch 


Submerged  Experiences  293 

bar,  eating  a  raw-meat  sandwich,  heavily  seasoned. 
He  felt  dizzy,  but  had  no  bad  taste  in  his  mouth,  no 
fetid  smell,  no  nausea.  He  sat  down  in  a  chair  and 
was  unconscious  for  two  minutes.  It  was  told  him 
that  during  that  time  he  attempted  to  remove  his 
shoes.  In  the  second  attack,  there  was  no  aura 
nor  any  unconsciousness,  merely  a  passing  dizziness. 

Further  recovery  of  the  amnesic  content  proceeded 
as  follows  : 

"It  was  on  the  elevated  platform,  down-town  side. 
I  was  with  a  girl.  I  was  sitting  beside  her  on  a 
bench  talking  about  coming  to  see  her  again,  then  I 
lost  my  mind.  I  remember  now  wanting  to  go  away 
with  her,  but  she  laid  her  hand  on  my  arm  ;  I  remem- 
ber I  sat  at  her  left  side,  and  she  said,  '  I  will  go 
home  with  you,'  and  I  said  '  I  was  all  right,'  and  I 
woke  up."  "  The  next  time  I  was  at  Emil's,  a  friend 
of  mine  ;  we  were  playing  cards,  and  I  lost  my  mind 
again  ;  his  wife  was  scared,  and  she  said  to  carry  me 
to  the  bed,  and  he  say,  '  Never  mind,  he  will  soon  be 
out.'  I  remember  how  she  looked.  Yes,  I  tasted 
the  bad  taste  of  the  meat  this  time  and  the  other." 

After  a  brief  interval,  he  said  :  "  It  was  in  the  ship- 
commissioner's  office  ;  I  taste  a  bad  taste,  and  then  I 
sit  on  a  bench,  and  then  I  fall  down  on  the  floor. 
Yes,  I  see  what  they  do  ;  the  commissioner,  he  hol- 
lered to  the  man,  '  What  is  the  matter  with  that  man  ? 
come  help  me.'  And  they  come,  and  pick  me  up  and 
put  me  on  a  bench.     Then  the  commissioner,  he  tell 


294         Psychopathological  Researches 

the  other  man  to  get  a  glass  of  water,  that  he  knows 
me ;  and  then  the  other  man  he  asks  about  me. 
Then  I  sit  there  still,  and  they  put  the  discharge  in 
my  pocket,  and  then  the  commissioner  tells  the  other 
man  to  take  me  to  the  doctor's.  Then  he  leads  me 
to  the  doctor,  down  the  stairs,  and  when  I  get  on  the 
street  I  wake  up." 

A  period  of  seven  months  intervened  between  these 
two  last  attacks.  During  this  time,  he  had  been  en- 
gaged in  the  Spanish  War. 

Dating  from  the  18th  of  November,  investigation 
has  been  pushed  more  rapidly.  Under  hypnosis,  the 
following  memories  emerge  : 

"Yes,  I  was  walking  up  and  down  the  bar-room, 
and  talking,  when  I  taste  the  bad  taste  in  my  mouth, 
and  I  think  I  go  up  stairs  and  lie  down  ;  when  I  get 
up  to  the  sixth  stair,  I  get  dizzy  and  fall  back,  then 
the  barkeeper  he  run  out  for  help,  and  Steffer,  he 
come  and  they  took  me  on  a  chair  near  the  door  ; 
then  I  sat  down  and  looked  at  them,  and  the  bar- 
keeper, he  said  to  Steffer,  '  I  think  he  break  his 
bones';  and  Steffer,  he  say,  "No,  for  he  is  in  no 
pain  ;  we  take  him  up  to  bed  and  leave  him  there  an 
hour.'  Then  they  carry  me  up  and  lay  me  down, 
and  the  barkeeper,  he  say,  '  It  is  lucky  he  not  break 
his  neck,'  and  then  I  goes  to  sleep." 

The  barkeeper  verified  the  details  of  this  attack. 
He  said  that  the  patient  fell  back  with  great  force, 
and    lay    for  several   moments  entirely  unconscious, 


Submerged  Experiences  295 

and  that  he  recalled  speaking  to  another  man  about 
it  as  the  patient  lay  there. 

The  patient  in  hypnosis  continues  :  "  I  was  sitting 
playing  cards,  and  a  friend  of  mine  and  a  boss  was 
sitting  there,  and  then  I  had  a  cramp,  and  dropped 
the  cards,  and  fell  back  in  the  chair,  and  my  friend,  he 
asked  the  boss,  '  What  is  the  matter  with  William  ? ' 
and  the  boss,  he  say,  '  Let  him  be,  he  get  it  often,  he 
be  all  right.'  /  tried  to  get  off  my  shoes,  because  I 
had  some  pain  in  the  small  toe,  and  then  they  stopped 
me  on  that  by  holding  my  arms,  and  then  I  wake  up. 
I  had  the  bad  taste  too."  It  is  to  be  noted  in  the 
next  memories  that  the  moment  of  falling  asleep  is  as 
clearly  demarcated  from  the  termination  of  the  dis- 
sociated period  as  is  the  moment  of  awakening. 

He  said  :  "  I  was  on  the  St.  Louis,  coming  off  the 
watch,  and  I  go  to  the  wash-room,  and  get  my  shirt 
off,  and  start  to  wash,  and  then  I  drop  down.  Beside 
me  stands  Ted  Horner  and  an  Irishman,  named 
Kennedy.  The  Irish  fellow,  he  say  to  the  other, 
'What  is  the  matter  with  that  fellow?'  'Fred,'  he 
say,  '  never  mind  him,  he  will  be  all  right.'  Then  they 
lift  me  up  and  take  me  to  the  forecastle  and  put  me 
to  bed.  The  Irish  fellow,  he  say,  '  I  go  for  a  doctor,' 
and  Horner,  he  say,  '  Let  him  be,  never  mind.'  They 
was  sitting  around  the  table,  and  they  ask,  '  What  is 
the  matter  ? '  I  said  nothing,  and  soon  I  went  to 
sleep.  I  saw  Horner  standing  beside  me,  as  I  went 
to  sleep." 


296  Psychopathological  Researches 

The  emergence  of  the  dissociated  subconscious 
memories  is  far  easier  than  at  the  beginning  of  the 
investigation.  The  recovered  subconscious  memories 
have  never  again  lapsed. 

In  the  next  hypnosis  work  was  continued  as  before. 

He  said  :  "  I  was  standing  in  the  saloon  after  my 
trip,  standing  in  front  of  the  bar,  and  I  have  an  argu- 
ment about  the  war.  Then  I  get  excited  and  fall 
down  in  front  of  the  bar.  The  boss  come  around  and 
tell  the  man  to  leave  this  man  alone,  for  he  knows 
what  is  the  matter  with  him.  Then  he  get  hold  of 
my  shoulders  and  put  me  in  the  chair,  and  he  says  to 
the  man,  '  Let  him  sleep  here  a  little  bit.'  The  other 
men  were  looking  at  me,  but  I  said  nothing.  Then 
two  fellows  get  hold  of  my  hand  and  keep  them  open, 
for  I  kept  my  hands  closed,  because  I  had  a  sort  of 
pain  that  kept  the  fingers  together.  As  the  men  stood 
there  looking  at  me,  one  said,  '  I  wonder  where  he  get 
that  sickness  from,'  and  the  other  say,  'It  is  a  bad 
thing  for  that  man,'  and  then  soon  I  wake  up." 

After  a  short  interval  patient  continued  :  "  I  was 
sitting  at  the  table  in  the  bar-room,  playing  cards, 
and  I  feel  bad  with  a  bad  taste,  and  I  tell  the  man  I 
don't  feel  good,  and  that  he  should  wait.  The  boss 
he  come  out  and  ask  me,  '  What  is  the  matter,  Wil- 
liam ? '  And  he  come  in  front  of  me  and  say,  '  Wil- 
liam, what  are  you  looking  for  ? '  I  was  looking 
through  my  pockets.  I  tell  him  I  have  a  letter  this 
morning,   and   I   was  looking  for  it.      And  he  says, 


Submerged  Experiences  297 

'  You  have  got  him  in  your  pocket,'  and  I  say, 
'  No,  I  can't  find  him,'  and  he  get  hold  of  my  hands 
and  keep  them  away  from  my  pockets,  and  then  I  re- 
member some  one  else  saying  that  when  he  goes  up 
stairs  he  had  it  in  his  hand.  The  boss  told  him  to 
'  Watch  him,  that  he  don't  fall  out  of  the  chair,  and 
then  soon  he  wake  up.'" 

We  have  in  these  subconscious  memories  an  exam- 
ple of  a  consistent  psychological  explanation  of  those 
peculiar  movements  so  often  described  as  occurring  in 
epilepsies.  This  closing  of  hand,  clutching  of  fingers, 
fumbling  through  pockets,  all  of  which  actions  would 
be  usually  regarded  as  "  purposeless,"  movements 
characteristic  of  epileptic  seizures,  are  really  the 
psychomotor  manifestations  of  lapsed  dissociated 
memories. 

The  patient  was  again  seen  early  in  December. 
He  reported  having  had  four  attacks,  upon  the  2 2d, 
25th,  26th,  and  27th  of  November.  All  of  these  at- 
tacks were  readily  recovered  in  hypnosis.  The  at- 
tack upon  the  2 2d  had  occurred  on  a  street  car.  The 
lapse  was  very  brief.  On  the  25th,  it  had  occurred  in 
a  saloon.  The  subsequent  amnesia  was  very  slight, 
as  he  recalled  nearly  all  the  details.  Those  upon 
the  26th  and  27th  were  mere  attacks  of  dizziness, 
with  no  loss  of  consciousness.  No  aura  was  present. 
These  attacks  of  dizziness  were  found  to  be  very 
persistent. 

The  revival  of  the  subconscious  memories  is  con- 


298  Psychopathological  Researches 

tinued  :  "  I  was  on  board  the  Paris.  I  go  on  watch 
and  start  to  clear  up  the  fire.  I  had  out  half  the  fire, 
when  I  dropped  down  in  the  corner.  The  trimmer  he 
called  out  for  a  fireman  for  the  centre  boiler.  He  said, 
'  Come  here,  quick,  and  look  what  is  the  matter  with 
William,'  and  he  say,  '  Take  hold  of  his  arm  and  pull 
him  this  side.'  They  get  hold  of  both  arms  and  pull 
me  back  in  the  corner.  The  trimmer  he  asks  the  fire- 
man, '  Shall  I  send  for  the  engineer?'  He  say,  '  No, 
leave  him  here  alone.  Go  ahead  and  get  the  steam 
up.  He  will  be  all  right  in  a  couple  of  minutes.'  The 
trimmer  he  started  to  clear  the  fire,  and  the  fireman 
came  in  with  a  cup  of  water  and  asked,  if  I  wanted  a 
drink.  Then  I  waked  up  after  that,  as  he  stand  in 
front  of  me  with  the  water." 

"  It  was  in  the  bar-room,  along  with  Henry  Barr, 
after  I  come  home  from  the  ship.  Then  I  get  paid 
off  and  sit  playing  cards  with  two  friends,  and  when 
we  were  playing  a  half  an  hour  I  feel  bad  and  put  my 
head  on  the  table.  One  fellow,  named  Fred,  he  called 
the  boss  and  say, '  Henry,  come  here  quick,  William 
get  it  again,'  and  then  he  get  hold  of  my  two  hands 
and  pull  the  fingers  straight.  I  thought  I  had  the 
cards  in  my  hand.  The  boss  he  said,  '  Don't  ask 
William  to  play  cards  again,  for  every  time  he  plays 
he  gets  that  sickness.'  Then  one  fellow  say,  '  We  did 
ask  him  if  he  feel  all  right,  and  he  say  "Yes,"  so  we 
play.'     Then  I  wake  up." 

There  is  to  be  noted    here    the  clutching    of   the 


Submerged  Experiences  299 

hands  as  a  motor  phenomenon  analogous  to  the  phe- 
nomena previously  mentioned.  The  patient's  appear- 
ance was  greatly  improved,  the  apathy,  depression, 
and  tendency  towards  a  state  of  dejection  diminished 
in  intensity.  This  state  of  depression  is  found  to  be 
largely  dependent  on  the  particular  state  of  mental 
dissociation.  Not  only  is  there  a  dim  knowledge  of 
the  occurrence  of  the  attacks,  but  there  is  as  well  a  faint 
apprehension  of  the  submerged  experiences  by  the 
waking  consciousness.  The  gap  is  dimly  felt.  At 
times  the  subconscious  memories  almost  emerge. 
The  patient  has  frequently  said  that  just  before  fall- 
ing asleep,  it  seems  as  if  he  couM  almost  remember. 
When  he,  however,  attempted  this,  all  was  dark. 
Moreover,  his  depression  was  most  acute  upon 
awakening  ;  his  thoughts  were  very  confused.  Espec- 
ially has  this  been  the  case  after  a  night  of  singularly 
distressing  dreams.  These  dreams  might  well  con- 
tain much  of  the  lost  memories.  The  hiatus  upon 
awaking  was  deep  ;  the  recall  was  faulty.  The  change 
in  these  factors  was  being  effected  by  reason  of  the 
wider  synthesis. 

On  the  5th  of  December,  work  was  continued 
along  the  same  line. 

He  said  :  "  I  was  in  front  of  the  house,  standing 
and  speaking  to  a  man,  when  I  feel  bad  and  drop 
down  there.  He  opened  the  door  and  called,  '  Come 
out  here,  somebody,  William  is  sick.'  A  fellow 
come  out  and  get  hold  of  my  arms  and  lift  me  up 


300  Psychopathological  Researches 

and  put  me  on  a  chair  at  the  table.  And  he  say 
to  the  boss :  '  That  fellow  is  getting  worse  all  the 
time.  That  is  the  second  time  he  get  them  here 
from  the  trip.'  Then  two  were  standing  in  front  of 
me  looking  at  me,  and  they  tell  me  that  I  had  best 
go  upstairs ;  the  boss,  he  tell  them,  '  Leave  that  man 
alone,  let  him  come  to  himself '  ;  and  then  I  get  off 
the  chair  and  walk  up  and  down,  and  then  I  wake  up 
when  I  was  walking." 

After  an  interval,  the  next  revival  of  attacks  was 
entered  upon. 

He  said  :  "  I  was  on  board  the  Paris,  and  we  left 
Southampton  for  New  York.  The  first  watch,  I 
come  up  and  go  to  the  wash-house  and  start  to  wash, 
and  fall  down  there  ;  the  fellow  he  get  hold  of  my 
arm  and  he  try  to  lift  me  up,  and  he  could  n't  get  me 
up,  and  he  was  standing  alongside  of  me  watching 
me.  I  lay  there  about  a  minute,  and  I  get  up  and  go 
out,  and  a  fellow  came  after  me,  as  I  was  going  down 
to  the  sailors'  room.  He  say,  '  Come  this  way,  this 
is  your  room ' ;  and  he  get  hold  of  my  arm  and  pull 
me  to  the  other  door,  and  get  in  front  of  me  and  get 
me  down  the  stairs,  and  put  me  in  the  bottom  bunk. 
The  other  men,  they  ask  him  what  is  the  matter  with 
me,  and  he  say  :  'He  is  all  right ;  let  him  lay  there  ; 
in  a  minute  he  will  be  all  right.'     I  wake  up  soon." 

The  next  attack  recalled  was  as  follows  :  "  I  come 
home  from  work  in  the  factory  at  Staten  Island  ;  I 
have  the  bad  taste  in  my  mouth,  and  I  drop  down 


Submerged  Experiences  301 

in  front  of  the  house  ;  I  have  been  laying  there  one 
minute,  and  a  man  come  out  and  look  at  me,  and  he 
called  his  wife,  saying  :  '  Come  out  here  and  see  what 
ails  this  man  ;  he  lays  here  in  front  of  the  house.' 
His  wife,  she  say,  '  What  can  that  be?'  Then  the 
man  said  to  her,  '  Come  out  and  get  hold  of  him,  and 
we  will  get  him  in  the  house.'  And  they  pull  me  in 
the  house  and  leave  me  on  the  floor,  and  his  wife  say, 
'  Go  get  something  to  put  under  his  head.'  I  lay 
there  a  minute,  and  then  I  wake  up  and  walk  out." 


CHAPTER  IV 

LAPSED    PERIODS    AND    HYPNOIDAL    STATES 

At  this  time,  one  feature  began  to  present  itself 
very  forcibly  :  the  state  in  which  the  patient  awakened 
from  hypnosis  became  more  and  more  one  of  confu- 
sion. He  seemed  not  to  be  thoroughly  aroused  for 
several  moments.  His  intelligence  was  confused. 
The  emerged  memories  were  completely  dominant ; 
his  expression  being  that  of  one  oblivious  to  all 
things  about  him.  It  was  a  question  as  to  what  de- 
gree these  memories  were  being  really  reassociated. 
There  remained  the  additional  question  as  to  whether 
the  frequent  and  deep  dissociations  produced  in  hyp- 
nosis were  not  of  themselves  conditioning  further 
dissociations.  For  the  past  month,  there  usually  oc- 
curred an  attack  upon  the  same  day  that  he  had  been 
hypnotized.  This  was  exemplified  upon  the  occasion 
of  his  last  hypnosis.  On  the  afternoon  of  this  day, 
when  emerging  from  the  theatre,  he  had  fallen  in  the 
street.  His  attack  was  short,  but  apparently  accom- 
panied by  entire  loss  of  consciousness.  The  content  of 
the  attack  was  later  fully  recovered.  There  was  no  aura. 

On  the  following  day,  he  had  a  lapse  at  the  clinic,  the 
entire  sequence  of  which  was  observed.  A  moment  after 

302 


Lapsed  Periods  and  Hypnoidal  States  303 

he  had  left  my  room  with  a  prescription,  the  orderly 
found  him  wandering  about  in  the  chemical  laboratory 
and  asked  the  patient  what  he  wanted.  The  patient 
replied  in  German,  that  it  was  his  own  business. 
The  orderly  recognized  his  condition,  and  brought 
him  to  me.  He  came  into  the  room  slowly  with  a  con- 
fused expression  of  surprise  and  inquiry.  He  appeared 
not  to  recognize  me,  nor  a  friend  of  his  at  that  time 
in  the  room.  I  made  him  sit  down  and  began  to 
question  him.  He  replied  in  German,  which  before 
he  had  never  spoken  to  me.  When  asked  where  he 
was,  he  said  he  knew,  but  that  it  did  not  make  any 
difference.  The  sensations  were  hurriedly  tested.  No 
apparent  change  was  discoverable.  No  memories  of 
previous  subconscious  states  could  be  elicited.  After 
a  moment,  his  head  sank  to  his  chest  and  his  eyes 
closed.  He  remained  thus  for  but  a  short  time. 
He  then  awakened.  He  remembered  only  that  after 
leaving  the  room  he  had  been  severely  reprimanded 
by  the  drug  clerk.  Further  than  this  he  knew 
nothing.  He  was  now  hypnotized.  The  content 
could  only  be  partially  recovered  at  this  time. 

When  next  seen,  upon  the  17th  of  December,  he 
reported  as  having  had  frequent  attacks  for  one 
week,  dating  from  the  7th.  No  aura  was  present  in 
any  of  these  attacks,  and  there  was  but  once  slight 
dizziness.  His  appearance  was  exceedingly  poor. 
His  eyes  and  nose  were  freely  discharging ;  his 
skin    covered  with    furuncles ;    he    appeared    stupid. 


304  Psychopathological  Researches 

When  accused  of  taking  medicines  other  than  those 
ordered,  he  confessed  that  he  had  bought  some  patent 
cure  for  epilepsy,  which  he  had  been  taking  for  a  few 
weeks.  The  only  medication  previously  taken  had 
been  morning  doses  of  sodium  phosphate.  It  was 
clear  that  this  patent  medicine  had  produced  a  state 
possibly  favoring  a  more  ready  dissociation.  It  was 
equally  certain,  however,  that  a  method,  other  than 
that  of  hypnotization,  must  be  employed  in  estab- 
lishing the  reassociation.  From  this  time  on,  the 
hypnoidal  method  was  employed. 

Dr.  Sidis  has  originated  and  used  this  particular 
means  in  many  different  cases.  The  psychological 
implications  will  be  found  fully  established  in  his 
work,  The  Psychology  of  Suggestion.  This  method 
consists  in  producing  a  state  of  abstraction,  of  mental 
composure  and  relaxation.  In  this  state,  termed  the 
hypnoidal,  "  the  upper  consciousness  takes  direct  cog- 
nizance of  these  states  or  memories  in  the  moment  of 
their  appearance."  They  are  immediately  reasso- 
ciated.  There  is  no  deep  dissociation,  such  as  is  pro- 
duced during  hypnotization.  Its  effect  is  radically 
different  as  will  later  be  demonstrated.  This  method 
was  highly  efficient  in  the  present  case,  and  the  fol- 
lowing memories  were  readily  recovered. 

He  said  :  "  It  was  in  a  house  where  I  lived.  I  was 
sitting  at  the  table  with  Horner  and  Barr,  playing 
cards  for  two  hours,  and  I  just  had  to  deal  cards,  and 
I  fell  in  my  chair.      Horner,  he  told  Barr,  '  Get  hold. 


Lapsed  Periods  and  Hypnoidal  States  305 

Don't  let  him  drop  down.'  Barr,  he  get  hold  of  my 
arms  and  keep  me  in  the  chair.  I  was  sitting  there 
for  two  minutes.  They  were  looking  at  me.  The 
boss,  he  say  :  '  Don't  ask  him  any  more  to  play  cards. 
It  don't  do  him  any  good.'  Then  I  wake  up.  After 
that  I  try  to  deal  cards,  and  the  boss,  he  say,  'Just 
wait  a  minute,  William,'  and  then  I  was  weak,  but  in 
my  right  mind,  and  I  say  '  I  have  to  deal  these  cards,' 
and  the  boss,  he  say,  '  No,  William,  you  don't  play  no 
more  cards.' '  Following  this,  he  continued  :  "  The 
next  time  I  was  in  my  own  room,  and  I  just  take  my 
clothes  off  and  I  drop  down  on  the  floor  and  I  hit  my 
head  against  the  trunk.  I  was  laying  there  for  ten 
minutes,  and  I  get  up  on  my  feet,  get  a  glass  and  put 
in  it  some  water  and  drink  it,  and  sit  down  on  the  bed, 
and  then  I  wake  up  while  I  was  sitting  on  the  bed, 
and  I  have  a  pain  in  my  head.  I  look  in  the  glass 
and  see  I  am  skinned,  and  I  wonder  whether  I  have 
it  in  my  own  room,  and  I  go  down  then  and  look  at 
the  clock,  and  it  was  half  an  hour.  I  was  up  in  my 
own  room.  I  remember  lying  on  the  floor.  My  eyes 
were  open,  and  I  was  thinking  about  that  letter  from 
the  girl  that  I  got  in  the  afternoon,  and  in  it  she 
asked  me  why  I  do  not  write.  I  had  just  read  the 
letter  in  the  room  again  when  I  fell  down.  As  I  sit 
on  the  bed,  I  put  my  head  in  my  hand  and  I  think 
about  the  girl.  It  was  in  my  mind  to  give  her  up.  I 
sit  there  a  few  minutes,  and  then  I  get  up  and  get  a 
drink  of  water  and  sit  on  the  trunk.      I  was  thinking 


306  Psychopathological  Researches 

how  I  got  that  in  my  head.     This  was  all  after  I 
wake  up." 

There  is  to  be  noted  here  the  markedly  increased 
wealth  of  detail.  There  follows  the  third  revival. 
He  said  :  "  I  was  walking  in  the  saloon  up  and  down. 
I  feel  a  headache  all  the  morning.  Then  I  feel  the 
bad  taste  coming  up.  Then  I  try  to  get  in  the 
closet  before  any  one  see  me,  but  I  could  n't,  and  I 
drop  down,  and  the  lunchman,  he  come  and  say  to 
Theodore,  '  Come  here,  William  is  down.'  Then  they 
get  me  on  my  feet,  and  I  start  to  take  off  my  coat  and 
vest  and  my  shoes,  but  the  lunchman  stop  me.  I  had 
to  go  out  that  day,  and  an  hour  before  I  wished  to  go 
up  and  get  ready.  I  think  then  that  I  was  in  my  own 
room.  Then  two  young  friends  say  to  the  boss,  '  We 
take  him  to  his  room.'  When  I  was  up  two  steps  I 
wake  up,  and  as  I  wake  up  I  say  :  '  What  is  the  matter 
with  you  ?     Why  don't  you  leave  me  alone  ? ' ' 

When  this  hypnoidization  ceased,  there  was  no  con- 
fusion in  the  patient's  demeanor,  action,  or  utterance. 
He  said  to  me  :  "  I  feel  now  very  different  from  the 
other  times.  Then  when  I  open  my  eyes  I  do  not 
know  where  I  am  ;  I  feel  lost,  and  many  times  that 
same  day  I  feel  lost.  Now  I  feel  just  the  same  as 
ever.  When  I  lay  down  and  am  remembering,  I  feel 
just  as  awake  as  I  do  now.  I  know  everything.  I 
know  what  is  going  on.  Before,  I  knew  nothing  at 
all." 

The  patient  was  seen  two  days  later.     He  reported 


Lapsed  Periods  and  Hypnoidal  States  307 

that  for  the  first  time  certain  attacks  had  been  re- 
called, other  than  those  reassociated  in  hypnosis.  He 
cannot  develop  these  fully,  some  of  the  material  being 
missing.  These  memories  emerged  as  he  lay  upon 
his  bed,  after  reading  a  paper,  when  in  a  state  of  ab- 
straction. These  additional  revivals  were  due  to  no 
post-hypnotic  suggestion.  They  were  entirely  deriva- 
tive from  the  hypnoidal  states. 

Under  the  same  methods  of  hypnoidization  work 
was  continued. 

"  I  was  sitting  on  a  chair  in  the  saloon,  close  to  the 
door.  I  feel  heavy  in  my  head,  and  I  drop  from  the 
chair  on  to  the  floor,  sideways.  A  fellow  stood  along- 
side of  me,  and  he  called  the  boss  :  '  Come  here.  Give 
me  a  hand.  Lift  William  up.'  They  put  me  back 
on  the  chair,  six  more  men  standing  around  me.  The 
boss,  he  says  :  '  It  is  getting  worser  with  William  all 
the  time.  He  must  go  and  see  a  doctor.'  Then  the 
other  fellow  says,  '  When  he  wakes  up  he  must  go  to 
the  dispensary.'  The  boss  says,  '  Bellevue  is  good.' 
Soon  after  this  I  wake  up  and  the  boss  is  standing  in 
front  of  me,  and  he  asked  whether  I  knew  I  had  had 
an  attack,  and  I  say,  '  No,  I  did  not'  "  The  next  re- 
vival followed  rapidly. 

He  said  :  "  It  was  in  the  afternoon  of  the  same  day, 
about  four  o'clock.  I  had  an  argument  with  a  man 
who  worked  on  the  coal  at  the  dock.  I  was  looking 
at  him.  I  fall  down  in  front  of  the  lunch  bar.  The 
lunchman  put  me  on  the  chair  that  stands  in  front  of 


308  Psychopathological  Researches 

the  bar.  The  fellow  that  had  the  argument,  and  the 
lunchman  said  to  him  :  '  You  stay  away.  What  for 
you  make  trouble  with  him?'  And  I  was  sitting 
there  another  minute,  and  the  lunchman  in  front  of 
me,  and  more  people,  but  they  keep  them  back,  and 
then  I  woke  up.  After  I  woke  up  I  was  a  little  bit 
tired." 

In  the  succeeding  attack  the  increasing  detail  is  to 
be  noted.  He  said  :  "  It  was  in  Battery  Park.  I  was 
walking  along  the  water  side.  A  fellow  was  with  me. 
I  say, '  I  feel  bad,'  and  he  say, '  Come  along  with  me,' 
and  I  drop  down  right  away,  and  some  fellow  come  to 
the  bench  and  ask  what  is  the  matter,  and  my  friend, 
he  say,  '  It  is  nothing ' ;  then  one  of  the  fellows  ask,  if 
he  had  it  before,  and  my  friend  say,  '  Yes.'  Then  the 
policeman  come  and  ask  if  he  is  drunk,  and  my  friend 
say,  '  No,  he  has  had  no  drinks.'  The  policeman  asks 
where  he  live,  and  my  friend  he  gave  my  address. 
Then  the  policeman  drive  the  others  back  and  say, 
'  Give  him  air,'  and  he  say  to  my  friend,  '  Come,  help 
to  put  him  on  the  bench.'  The  police,  he  ask,  ■  Do 
you  think  he  get  better?'  My  friend  say,  'Yes,  in 
two  or  three  minutes.'  Then  I  begin  to  look  through 
my  pockets  for  some  cigars  I  had,  and  then  I  wake 
up.  After  I  wake  up,  the  policeman  tell  me  I  had 
better  go  home." 

Attention  should  be  directed  in  the  following  at- 
tack to  the  character  of  the  motor  phenomena  pre- 
sent as  he  lay  upon  the  floor. 


Lapsed  Periods  and  Hypnoidal  States    309 

He  said  :  "  I  was  standing  in  front  of  the  lunch 
bar,  and  I  feel  a  bad  taste  in  my  mouth,  and  I  try  to 
get  in  the  closet,  but  I  could  not,  and  I  fall  in  front 
of  the  lunch  bar.  There  was  a  couple  of  people 
there,  and  they  get  hold  of  me  and  lift  me  up,  and 
the  lunchman  say,  '  Leave  him  lay  there.'  One  of 
the  fellows  say,  '  I  never  see  that  in  William  before.' 
The  lunchman  say,  '  He  get  it  very  often  now.'  And 
then  I  start  to  hit  arotcnd  with  my  arms  and  legs.  I 
want  to  get  room  around  me.  I  kick  with  my  feet. 
Some  white  stuff  come  out  of  my  mouth,  and  the 
lunchman  wipe  it  off  with  the  towel,  and  then  they 
put  me  on  my  feet  and  I  walk  up  and  down  for  a  few 
minutes.  I  walk  to  the  front  door  and  then  back, 
and  then  look  in  the  closet.  It  was  in  my  mind  that 
I  want  to  go  to  my  own  room,  and  I  go  to  the  door 
that  goes  up,  and  two  fellows  get  hold  of  me,  and  the 
lunchman  say,  '  Don't  let  him  go ' ;  and  then  I  go  to 
the  lunch  bar  and  get  a  piece  of  bread  and  smoked 
fish,  and,  eat  and  start  to  walk  again.  Then  the  boss's 
brother  come  out  and  walk  alongside  of  me.  The 
boss  say  :  '  Watch  him  good.  Don't  let  him  drop 
down.'  Then  I  wake  up.  I  felt  very  tired  after  I 
awake." 

The  lunchman,  a  person  of  more  than  average  in- 
telligence and  experience,  spoke  of  this  attack  :  "  A 
very  bad  one,  where  his  arms  and  legs  worked  and  he 
frothed  at  the  mouth."  This  was  a  very  fair  descrip- 
tion of  the  so-called  grand  mal.      It    was  evidently 


3io  Psychopathological  Researches 

marked  and  was  clearly  of  a  purely  functional  psychic 
nature. 

The  hypnoidal  states  were  continued  upon  the  next 
day.     Their  content  follows  : 

He  says  :  "  I  was  sitting  in  a  chair  and  I  fall  back, 
and  a  brother  of  the  boss,  he  say,  '  What  is  the  matter 
with  him  ?'  and  he  get  alongside  of  me  and  hold  me, 
and  I  come  to  myself.  I  was  listening  as  I  lay  back 
to  some  one  talking  about  the  boss.  Four  men  were 
in  the  saloon.  They  said  nothing,  but  looked  at  me. 
The  next  time,  I  was  standing  with  a  friend  of  mine 
at  the  bar.  He  asked  what  I  want.  I  say,  '  Nothing,' 
and  then  he  take  a  drink,  and  then  I  have  the  bad 
feeling  and  he  carry  me  back  to  the  chair,  and  he  say 
to  the  boss  :  '  What  is  the  matter  with  William  ?  I 
know  him  for  a  long  time,  and  I  never  see  this  be- 
fore.' The  boss,  he  say,  '  He  get  it  a  good  many 
times.'  Then  the  man  say  :  '  It  is  just  the  thing  I  had 
in  the  German  Navy.  I  had  mine  from  the  drink.' 
Then  I  wanted  to  stand  up  from  the  chair,  and  they 
come  and  want  to  keep  me  in  the  chair,  and  I  sat 
there  another  moment,  and  then  I  wake  up.  While 
I  was  sitting  in  the  chair,  I  was  looking  at  them  and 
thinking  about  the  man.  I  think  to  myself,  he  is  a 
great  drinker,  only  he  keep  himself  good  and  well  all 
the  time." 

We  pass  rapidly  to  the  succeeding  states. 

He  said  :  "  I  was  sitting  in  the  chair,  with  the  boss. 
Two  men  were  playing  pinochle.     I  watched  them 


Lapsed  Periods  and  Hypnoidal  States  311 

play,  and  as  I  watched  them  I  feel  bad  in  my  head 
and  lean  back  in  my  chair.  The  bartender  he  say  : 
'  Look  at  William.  He  got  it  again.'  The  boss,  he 
stand  in  front  of  me  and  pull  my  fingers  straight.  I 
had  some  money  in  my  hand,  and  I  want  to  keep  hold 
of  it.  Then  the  boss,  he  tell  his  brother  not  to  let  me 
go  on  the  St.  Paul, — to  keep  me  here.  Then  I  fall 
asleep  and  sleep  a  few  minutes,  and  open  my  eyes, 
and  I  did  not  know  I  had  it." 

"In  the  next,  I  was  lying  in  the  bed  and  sleeping, 
and  then  I  get  up  and  walk  up  and  down  the  hallway. 
The  boss's  brother  come  out  and  say,  '  What  is  the 
matter  with  you,  William  ?'  I  gave  him  no  answer, 
for  we  had  trouble  the  night  before.  Then  he  get 
hold  of  my  arms  and  say,  '  Go  to  bed,  William,'  and 
push  me  in  the  room  and  lay  me  on  the  bed,  and  I 
lay  there  another  minute,  and  then  I  wake  up  and  see 
I  have  no  blanket  on  me.  I  think  I  have  an  attack. 
I  walked  in  the  hall,  because  I  was  hot  and  sweaty.  I 
was  thinking  that  I  told  the  boss  to  give  me  a  front 
room." 


CHAPTER  V 

HYPNOIDAL    STATES    AND    SYNTHESIS 

After  these  hypnoidal  states  were  discontinued  for 
the  day,  the  patient  proceeded  to  enlarge  on  certain 
attacks  which  came  later  in  the  series  and  had  not 
been  revived  in  these  states.  Then,  passing  entirely 
over  the  attacks  which  had  been  previously  reasso- 
ciated,  he  arrived  at  the  last  attacks  in  the  series, 
namely,  those  which  had  occurred  at  the  hospital  on 
the  7th  of  December  and  a  few  days  following. 

He  recalled  the  hospital  attack  perfectly — described 
with  great  accuracy  where  he  had  been,  whom  and 
what  he  had  seen,  what  had  been  said  to  him,  and 
what  had  been  his  replies.  These  memories  had  not 
been  revived  with  any  degree  of  success  under  hyp- 
nosis. At  this  time,  however,  they  were  perfectly 
recalled.  No  new  causative  factor  other  than  the 
hypnoidal  states  had  been  introduced.  It  was  the 
hypnoidal  states  alone  which  had  initiated  the  greater 
degree  of  synthesis. 

In  the  hypnoidal  states  which  now  followed,  much 
of  the  content  had  been  reassociated  in  the  interval. 
The  revival  continued  as  follows : 

He  said  :  "  I  was  on  the  6V.  Paul,  when  we  were 

312 


Hypnoidal  States  and  Synthesis        313 

coming  home  from  England,  and  I  was  on  watch,  and 
I  had  the  bad  feeling  and  fall  down.  The  trimmer 
puts  me  on  the  side  and  runs  to  the  engine  room  and 
gets  the  engineer.  He  say  to  the  engineer, '  What  is 
the  matter  with  the  man  ? '  The  engineer  say,  '  Get 
hold  of  his  feet  and  carry  him  to  the  passageway, 
where  there  is  more  breeze.'  Then  two  fellows  come 
and  look  at  me,  and  the  engineer  ask,  if  you  ever  see 
that  before.  One  of  the  fellows  say  :  '  Yes,  I  was  on 
the  Paris  with  him.  It  won't  take  long.'  And  then 
one  gets  water  and  lifts  my  head  up,  and  I  wake  up." 

The  next :  "  I  sit  in  the  bar-room,  and  some  one 
say,  '  Come  out,  some  one  wants  to  see  you.'  I  go 
out,  and  Lizzie  was  there,  and  we  were  standing.  She 
say:  'You  look  pale  in  the  face.  You  feel  bad.'  I 
say :  '  No,  I  feel  all  right.  If  you  go  home,  I  will 
walk  with  you.'  She  say  :  '  No,  you  stay  here.  You 
look  so  bad.'  Then  I  fall  down  against  the  steps.  I 
lay  there  a  moment,  and  Lizzie,  she  say,  'William, 
what  is  the  matter  ? '  She  get  hold  of  me  and  try  to 
get  me  on  the  steps.  Then  I  get  up  on  my  feet,  and 
they  tell  me  to  go  home.  Then  I  say  :  '  I  am  all 
right.  I  am  not  sick.'  Then  they  brought  me  before 
the  house,  and  they  call  some  one  out  to  bring  Wil- 
liam upstairs.  When  I  came  in  my  own  room,  I 
wake  up." 

He  continued  :  "  The  next  time,  I  was  walking  up 
and  down  in  the  saloon,  when  I  feel  bad  in  the  throat, 
and  I  sit  down  in  the  chair.     The  lunchman,  he  say, 


3H  Psychopathological  Researches 

'What  is  the  matter?'  Then  the  longshoreman,  he 
come,  and  the  lunchman,  he  tell  him,  '  Keep  away.' 
Then  one  of  the  longshoremen  say,  '  I  never  see  a 
man  get  it  so  often  as  William  get  it.'  One  man  say- 
to  another,  '  Is  it  cramps,  or  what  is  it  ?'  The  lunch- 
man  say  :  '  Just  keep  away.  That  is  no  cramps.  He 
only  gets  it  when  he  gets  excited.  You  never  get 
cramps  when  you  get  excited.'  They  stand  in  front 
of  me  still.  Then  I  wake  up  and  go  to  the  front  door, 
and  come  back;  and  the  lunchman  ask,  if  I  knew  I  had 
it,  and  I  say  :  '  No.     Was  it  hard  ? '  " 

It  is  to  be  noted  that  the  aura  is  present  through- 
out all  the  attacks. 

He  continued  :  "  The  next  time,  I  feel  the  bad  taste 
and  pain.  I  sit  down  in  the  chair  in  the  bar-room.  I 
was  only  a  little  bit  dizzy.  I  see  everything  that  go 
on.     After  a  few  minutes,  I  get  up  on  my  feet." 

"  The  next  time,  I  was  coming  down-stairs,  and  I 
go  to  the  lunchman  and  I  sit  down  quick  in  the  chair 
and  he  say,  '  William,  you  want  any  coffee  ? '  and  I 
say :  '  No,  I  just  want  to  sit  here.  I  think  I  get  my 
trouble.'  I  sit  there  a  moment,  and  then  all  is  right. 
I  do  not  lose  my  senses." 

These  light  attacks  were  never  before  recalled  in 
such  detail.  Not  only  have  the  attacks  become  reas- 
sociated,  but  much  of  the  intervening  psychic  material 
which,  while  not  dissociated,  was  at  least  feebly  asso- 
ciated, has  become  synthetized.  It  will  be  remem- 
bered that  his  condition  previous  to  coming  to  the 


Hypnoidal  States  and  Synthesis        315 

hospital  had  been  very  confused.  It  will  further 
be  recalled  that  the  inception  of  a  continuous  am- 
nesia seemed  apparent  during  this  period.  This 
lapsed  content  has  now  been  accurately  reassociated. 
He  has  given  the  date  of  his  visit  to  the  clinic,  to  the 
Marine  Hospital,  and  to  the  Hudson  Street  Hospital. 
A  slight  mistake  made  at  this  time,  purposely  uncor- 
rected by  myself,  involving  the  date  of  his  first  visit 
to  me,  was  corrected  two  days  later.  He  said  that 
now  it  was  possible  for  him  to  think  of  the  whole 
series  as  they  had  occurred.  He  fully  appreciated 
that  only  for  the  past  ten  days  has  he  been  able  to 
grasp  them  so  clearly.  This  is  the  exact  period  of 
the  use  of  the  hypnoidal  method. 

He  sleeps  easily  and  quietly.  There  are  no  further 
dreams.  The  remarkable  change  in  his  behavior  has 
been  noted  by  all  his  acquaintances, — by  men  who  are 
not  over-ready  to  notice  fine  distinctions.  There  have 
been  no  further  attacks  of  any  nature.  He  feels  that 
there  will  be  none.  The  last  of  the  memories  are  now 
recovered  : 

He  said  :  "  I  was  on  the  Philadelphia,  on  my  watch, 
and  I  was  changing  my  clothes,  and  I  dropped  down. 
My  friend  come  and  look  at  me  and  put  me  on  the 
bench.  He  come  and  stand  and  look  at  me,  and  I 
was  lying  on  the  bunk.  Then  I  look  at  my  clothes, 
and  then  get  up  and  go  through  them.  I  was  looking 
for  some  tobacco.  The  other  fireman  put  me  back 
in  the  bunk,  and  I  start  and  sleep  there,  and  I  sleep 


316         Psychopathological  Researches 

only  a  few  minutes,  and  when  I  wake  up  all  the  fel- 
lows have  gone." 

The  next  time  :  "  Lizzie  was  coming  down,  and  I 
was  walking  with  her,  when  I  had  the  bad  taste  in  my 
throat  and  I  fall  down,  and  the  people  stop  and  look 
at  me.  She  say  to  them,  '  It  will  be  all  right.'  Then 
some  man  gave  her  a  hand  to  help  me  up,  and  they 
start  to  clean  my  clothes,  and  I  begin  to  walk  up  and 
down.  Then  she  said,  '  Do  you  feel  better?'  I  give 
no  answer,  because  I  have  some  pain,  and  I  would 
not  let  her  know  that  there  was  any.  Then  she  say, 
'  Come  on,  we  go  home.'  Then,  on  the  corner  of 
Cortlandt  Street,  I  come  to  myself.  I  did  not  know 
I  had  it." 

"  The  next  time,  I  was  in  the  fire-room  and  leaning 
against  the  ladder,  and  I  have  the  bad  taste  and  fall 
down.  The  fireman  he  come  and  lift  me  up  and  wet 
my  face.  The  water-tender  he  come  and  say,  '  Well, 
he  get  it  again.'  Then  I  get  up,  and  sit  down  and 
hold  my  head  in  my  hands.  The  water-tender,  he  say, 
'  He  will  be  all  right  soon.  We  don't  need  the  other 
man.'     Then  I  wake  up." 

"  The  next  time,  I  was  on  the  Si.  Paul.  I  feel  bad 
in  my  stomach  and  fall  down  quick.  The  fireman, 
who  was  working,  come  and  look  at  me.  He  say, 
'What  is  the  matter?'  Then  he  call  the  engineer, 
and  the  engineer  ask  if  he  had  it  before.  And 
the  fellow  say  :  '  Yes,  he  had  it  twice  before.  I  saw 
him.'    The  coal-passer,  he  take  my  fire.     I  was  sleepy 


Hypnoidal  States  and  Synthesis        317 

for  ten  minutes.  Then  the  engineer  come  and  ask 
me,  '  How  you  feel  now  ?'  and  I  wake  up." 

"  The  next  time,  I  was  sitting  in  the  saloon  on  a 
chair,  when  I  dropped  down.  Two  longshoremen 
picked  me  up.  I  started  to  take  my  coat  and  shoes 
off.  They  keep  hold  of  my  hands  and  stop  it.  The 
boss,  he  was  standing  in  front  of  me,  and  he  say, 
'  When  he  wake  up  I  will  tell  him  to  go  and  get  some 
medicine.'  Then  I  put  my  shoes  and  coat  on  and  sit 
up  for  a  minute.  /  take  my  shoes  and  coat  off,  because 
I  think  I  am  in  my  own  room.  When  I  put  them  on 
again,  I  do  it  because  I  see  I  am  in  the  saloon." 

The  hypnoidal  states  were  continued.  He  said  : 
"  I  was  in  the  saloon  when  I  feel  bad.  I  go  to  the 
closet,  that  no  one  should  see  me.  I  drop  down  and 
lay  there  a  minute,  and  the  lunchman  come  and  pick 
me  up.  He  say,  'What  do  you  do  here,  William?' 
I  say,  '  Let  me  alone.'  Then  I  drink  a  glass  of  water. 
Then  he  say,  '  Sit  on  a  chair  at  the  first  table.'  Soon 
I  wake  up  and  feel  tired." 

"  The  next  time,  I  was  walking  up  and  down  in  the 
saloon.  I  fall  down  by  the  lunch  bar.  The  lunch- 
man  come  from  behind  and  pick  me  up  and  put  me 
on  the  chair.  Some  people  come  and  look  at  me. 
The  lunchman  stand  in  front  and  keep  both  hands  on 
my  shoulders.  When  he  take  his  hands  from  my 
shoulders,  then  I  take  off  my  coat.  When  I  get  my 
shoes  off,  the  lunchman  he  say,  '  William,  you  not  up- 
stairs, but  down  here.'    Then  I  put  on  my  coat  again. 


318  Psychopathological  Researches 

Then  they  both  say,  '  I  wonder  what  he  thinks  when 
he  starts  to  put  his  coat  off.'  Then  they  put  some 
water  on  my  face  and  I  wake  up." 

A  few  lighter  attacks  occurring-  after  this  were  re- 
associated  by  the  patient  himself  without  the  use  of 
the  hypnoidal  method. 

The  patient  has  had  no  attacks.  His  condition, 
mental  and  physical,  is  widely  different  from  that  dis- 
played at  the  time,  when  first  seen.  He  is  well  and 
has  resumed  his  former  occupation. 

A  review  of  the  case  shows  a  genesis  of  the  aura 
and  recovery  of  experiences  of  the  psychomotor  at- 
tacks, experiences  belonging  to  dissociated  mental 
states.  It  shows  that  these  experiences,  although 
dissociated,  were  recoverable.  It  clearly  shows  that 
what  is  often  regarded  as  epilepsy  does  not  really  be- 
long there, — that  many  a  "  typical  "  epilepsy  may  on  a 
closer  study  turn  out  to  be  ■&  fun-ctional psychosis.  This 
is  especially  true  of  the  so-called  "  psychic  epilepsies," 
which,  as  the  psychopathological  researches  of  our  lab- 
oratory on  many  other  different  cases  incontestably 
demonstrate,  are  all  pure  functional  psychoses,  sub- 
conscious dissociated  states,  having  the  tendency  to 
recur,  periodically  or  not,  with  all  the  energy  charac- 
teristic of  a  fully  dissociated  system,  reproducing  the 
original  psychomotor  conditions  during  the  accident, 
and  often  closely  mimicking  the  psychomotor  mani- 
festations of  epilepsy.1     It  further  demonstrates  the 

1  See  Introduction,  also  pp.  199,  212. 


Hypnoidal  States  and  Synthesis        319 

possibility  in  this  case  of  recovering  all  the  dissociated 
memories  of  the  attacks.  But,  more  than  this,  it 
definitely  points  out  the  great  importance  of  bringing 
all  these  dissociated  memories  out  of  the  depths  of  the 
subconscious  and  reassociating  them  in  the  synthesis 
of  the  upper  personality,  restoring  all  the  lost  psychic 
material  to  the  contracted  active  personal  conscious- 
ness, and  thus  bringing  about  a  state  of  former  mental 
activity  which  will  maintain  the  formed  synthesis.1 

1  See  p.  218. 


INDEX 


Abbreviation,  process  of,  182,  183 
Aberration,     mental,    9 ;     vasomotor, 

275 

Abnormal,  9,  33,  148  ;  mental  life,  4; 
mental  process,  31  ;  states,  8,  147, 
148,  153  ;  suggestibility,  10 

Abnormalities,  34 

Aboulia,  10 

Abstract  notions,  200 

Acoustic,  74 

Activity,  92,  195,  211,  212  ;  intellec- 
tual, 106  ;  life,  182  ;  mental,  194  ; 
psychic,  9,  106,  182  ;  psychomotor, 
211  ;  reflex,  49  ;  spontaneous,  93  ; 
voluntary,  196 

Adaptability,  195,  197 

Adaptation,  22,  194,  196,  197 

Adjustment,  22,  195,  196 

Affective,  changes,  185  ;  emotional 
traits,  175  ;  state,  168,  170,  206  ; 
tone,  204 

Aggregate,  neuron,  212 

Alcohol,  use  of ,  117,  118 

Alcoholic,  intoxication,  121  ;  symp- 
toms, 115 

Alexia,  17,  30 

Alienation,  mental,  xv,  7,  30 

Alternating  states,  156 

Alternation,  process  of,  177 

Amnesia,  xi,  7,  10,  14,  42,  103,  106, 
107,  113,  117,  121,  174 

Anaesthesia,  xviii,  6,  10,  42,  45,  46, 
49,  71,  83,  85,  86,  92,  167,  266 

Anaesthetic  organ,  41,  45,  48,  71 

Analgesia,  49 

Analysis,  xx,  16  ;  introspective,   14 


Antiquity,  thinkers  of,  196 

Aphasia,  14,  15,  29  ;  auditory,  16/29; 
visual,  17 

Aphonia,  266,  267 

Apraxia,  16,  29 

Archoplasmic  structure,  199 

Area,  anaesthetic,  128,  267,  268  ;  pul- 
sating, 129;  of  retina,  130;  of 
waves,  179 

Artefacts,  27,  29 

Arthropoda,  195 

Artifices,  suggestion,  87,  88 

Ascent,  of  psychic  states,  174  ;  reverse 
process  of,  177 

Assimilation,  185,  188,  190 

Association,  197,  212,  229  ;  of  disag- 
gregated consciousness,  90,  91  ;  of 
ideas,  140,  165  ;  indirect,  53  ;  kin- 
aesthetic,  202  ;  of  neuron  systems, 
x  ;  of  representations,  182  ;  theory 
of,  15 

Associative  suggestion,  50,  51,  54 

Asthenopia,  129 

Astigmatism,  34,  127 

Atavism,  199 

Attacks,  33,  128,  144,  146,  149,  151, 
152,  212,  218,  284,  285,  287,  299, 

315 

Attention,  74,  108,  160,  163,  164, 
166,  172 

Auditory,  aphasia,  16,  29  ;  word  im- 
ages, 16 

Aura,  xix,  218,  282,  284,  303  ;  of  the 
secondary  state,  149 

Auto-erotism,  134 

Auto-intoxication,  198 


321 


322 


Index 


Automatic,  48,  49,  106,  117;  writing, 
59,  6r,  68,  82,  84,  85,  95,  100,  190 
Automatism,  xi,  122,  190,  212 

Biogenetic  law,  122,  184 
Biological,  4,   22,  182-184,  196,  199 
Biology,  3,  4,  27,  28 
Borderland,  91 

Cancer,  117,  164 

Cathode  ray,  2 

Cell,  3,  4  ;  reversion  of,  167 

Centrosome,  27,  199 

Cephalopods,  195 

Circular  insanity,  8,  175 

Circulation,  22 

Clinical  purposes,  50 

Color,  38 

Combination,  8 

Compounds,  182 

Concatenation  of  subconscious  per- 
sonalities, 182 

Concentric  circles,  173 

Conception,  183 

Concepts,  14 

Condensation,  process  of,  182,  184 

Consciousness,  18,  49,  50,  53,  55,  60, 
70,  73,  83,  100,  107,  108,  113,  116, 
121,  138,  147,  148,  I50.  152,  154. 
172,  I78,  l8l,  211,  212,  217,  2l8, 
276 

Constellations,  10,  53 

Contracted  field  of  vision,  34,  42,  70, 

98,  129 
Contractures,  xviii,  263 
Contrast,  association,  140  ;  effects,  17, 

175 
Control,  2,  11,  91,  126 
Convolutions,  17,  1 8 
Convulsions,  xviii,  120 
Convulsive  seizures,  34,  48 
Course  of  nervous  diseases,  198 
Crime,  113,  114.  Il6>  I21 
Crisis,  nervous,  48 
Curari,  198 
Current  of  thought,  161,  162,  194 


Curve,  psychopathic,  179 
Cycle,  psychopathic,  179,  180,  181 
Cytology,  27 
Cytoplasm,  xii 

Darwin,  xvii,  3 

Decisions  of  will,  18 

Degeneration,  x,  xi,  xii,  xiii,  xiv,  xvii, 
11,  17,  18,  198,  272 

Delusion,  14,  22,  30,  160,  161,  165- 
171,  188-190,  221,  240,  242 

Delusional  system,  166,  168,  185,  187, 
204,  205,  218,  219 

Dementia,  117 

Depression,  131,  168,  169,  171,  175, 
299 

Development,  of  aura,  149  ;  cell,  4;  of 
dissociated  system,  199  ;  of  muscu- 
lar system,  195  ;  of  suggestion,  188 

Differentiation,  36 

Direct,  internal  method,  6,  8  ;  subcon- 
scious reaction,  55  ;  suggestibility, 
10  ;  suggestion,  10 

Disaggregation,  x,  xi,  xii,  xiii,  xv,  10, 
241,  272 

Discrimination,  74,  76 

Disease,  xiii,  xvii,  168,  198 

Disintegration,  202,  205,  207,  216 ; 
mental,  19,  156  ;  process  of,  xx, 
198,  203,  216,  219 

Dissociated,  neuron-aggregate,  212  ; 
states,  95,  122,  141,  150,  154,  156; 
systems,  50,  54,  55,  62,  90,  93,  98, 
102,  154,  199,  211,  212,  273,  276 

Dissociation,  ix,  x,  xiii,  xiv,  17,  18, 
53,  85,  91,  102,  141,  154,  156,  197, 
198,  211,  272,  274,  299,  302,  304 

Dissolution,  mental,  13,  19,  207,  278  ; 
process  of,  216 

Distraction,  70,  72,  73,  78,  79,  84,  85, 
98,  100 ;  method  of,  66,  74  ;  state 
of,  68 

Disturbances,  motor,  255,  282  ;  patho- 
logical, 168  ;  psychomotor,  75,  218, 
262,  272,  273  ;  sensori-motor,  xi ; 
sensory,  167 


Index 


O^J 


Divergencies,  4 

Double,  consciousness,  xi,  152  ;  per- 
sonality, 107 

Dreams,  167,  207,  213,  214,  232,  236, 
247,  256,  264,  265,  272 

Dynamogenesis,  210,  211,  213 

Ebbinghaus,  7 
Educational  standpoint,  200 
Effort,  hypnoidal,  method  of,  108 
Electricity,  52,  84,  85,  238 
Elements,     177  ;    disintegrated,    203, 
210  ;  ideo-motor,  202  ;    motor,  193, 
237  ;    psychomotor,   197,    200  ;  sen- 
sori-motor,  202  ;  sensory,  182 
Elimination,    183  ;    process    of,    182, 

184 
Embryonic  type,  200 
Emotion,  8,  62,  64,  144,  171 
Emotional,    personalities,    206,    207  ; 
state,  61,   156,   170,  171,  241  ;  sub- 
stitution, 204 
Energy,  neuron,  86,  128,  212,  271 
Epilepsy,  larval,  212  ;  psychic,  xi,  xvi, 
xvii,  xviii,  xix,   149,    151,   152,    199, 
211,  212;  psychomotor,  xix,  280 
Epileptic,  equivalents,  212  ;    manifes- 
tations, 212 
Epileptoid,  disturbances,  xvi  ;    mani- 
festations, xix 
Epistaxis,  146 
Epitome,  of  the  past,  183  ;  of  phylo- 

geny,  184 
Equilibrium,    xv,  102,  218,  259 
Equinovalgus,  258 
Equivalents,  psychic,  xvi,  291 
Erythrophobia,  131,  144,  154,  156 
Euphoria,  170 

Evolution,  organic,  184  ;  theory  of,  3 
Evolutionary,  processes,   184  ;   series, 

184 
Exaltation,  state  of,  131,  148,  176 
Examination,  of  field  of  vision,  34  ;  of 
patient,  33,  128,  160,  222,  255,  264; 
of  sensibility,  36  ;    of   the   subcon- 
scious, 41 


Experiences,  17,  19,  22,  176,  182,  183, 
243  ;  subconscious,  53,  60,  61,  288, 
290 

Experimental  notes,  220 

Experiments,  11  ;  automatic  writing, 
46,  64,  66,  83-85  ;  fatigue,  186, 
229  ;  motor  ideas,  196  ;  on  person- 
ality metamorphosis,  57;  on  the  sub- 
conscious, 49-51,  53,  55,  56,  62,  64, 
66,  68,  70,  73,  76-81,  100 

Facts,  of  consciousness,  18  ;  illusory, 
27  ;  psychic,  21 

Fallacious  perception,  8,  30 

False  ideas,  30 

Fatigue,  dissociation,  131,  156;  ex- 
periments, 68,  186,  193,  229,  271 

Fechner,  7 

Feeling,  fusion  of,  182  ;  life  of,  173 

Fere,  264 

Field  of  vision,  34,  38,  41,  42,  70,  71, 
98,  100,  102,  129 

Fixation,  of  the  attention,  172;  mental, 
14 

Fixed  ideas,  xi,  9,  10,  14,  21 

Flow,  of  association,  165  ;  of  thought, 
194 

Folie  a  double  fon?ie,  175 

Forgetfulness,  7,  183 

Fragmentary  mental  groups,  218 

Fragments  of  disintegrated  systems, 
217 

Fraud  phenomena,  27 

Function,  mental,  9,  n  ;  of  presenta- 
tion, 9  ;  psychic,  8,  22,  23  ;  of  re- 
call, 7  ;  of  sensibility,  8 

Functional,  changes,  12  ;  derange- 
ments, 9;  insanity,  xi,  xv;  psychosis, 
ix,  x,  xi,  xii,  xiii,  xiv,  xv,  xvii,  12, 
19,  27,  32,  33,  284 

Genera,  evolution  of,  183 

General,  paresis,  8  ;  psychomotor 
states,   164 

Generalization  on  functional  psycho- 
sis, 10,  17,  18 

Gradations,  function  of  sensitivity,  8 


324 


Index 


Grand  mal,  116 

Greek  philosophers,  196 

Grief,  state  of,  176 

Groups,  pleasant,  241  ;  psychomotor, 

197 

Guessing,  method  of,  41 

Guiding,  delusional  system,  186  ;  per- 
sonages, 182 

Habit,  subconscious,  76,  81 
Habitual,  acts,    115  ;  hypnotic  state, 

62  ;  tracts,  53 
Hallucinations,  21,  43,  117.  il8-  l68> 

188,   193  ;   nature  of,  9  ;    negative, 

43,  51,  56,  57,  60,  85,  86,  131,  235; 

study  of,  14  ;  visual,  47 
Headache,  149,  265,  306 
Heredity,  4 
History,  biological,  23  ;  patient's,  33, 

125,  159,  160,  220,  222,  255,  264; 

phylogenetic,  183 
Hobbes,  28 

Homicide,  114;  idea,  140 
Hyperaemic,  34 
Hyperesthesia,  xviii,  8;  psychopathic, 

7i 
Hypermnesia,  7 
Hypnoidal  states,  103,  302,  304,  312  ; 

memory  experiments  in,  108-111 
Hypnoidization,  method  of,  107,  153, 

306,  307 
Hypnosis,  41,  72,  73,  77,  79~81,  9°> 

91,  95,  100,  102,  153,  171,  192,  193, 

203,  223,   226,  228,  230,  232,  233, 

235,  243 

Hypnotic  state,  95,  153,  187,  207, 
234  ;  anaesthesia  in,  45  ;  habitual, 
62  ;  memory  in,  40  ;  negative  hallu- 
cinations in,  45  ;  pleasant  moods  in, 
209,  242,  252  ;  pneumographic  trac- 
ings in,  65  ;  rapport  in,  50  ;  vision 
after,  42 

Hyposesthesia,  xviii,  8 

Hypochondriacal  melancholia,  169 

Hypomnesia,  7 

Hysteria,  25,  26,  258 


Ideas,  association  of,  165  ;  fixed,  10, 
218  ;  insistent,  166  ;  kinsesthetic, 
202 ;  motor,  194,  196,  200 

Ideo-motor  life,  193 

Illusions,  9,  30,  165,  168,  193 

Images,  15.  18,  20;  auditory  word, 
16  ;  visual  word,  17 

Immediate  associative  suggestion,  51, 
56 

Impressions,  incoming,  6 ;  subcon- 
scious, 51,  73 

Impulses,  9,  14,  168,  199 

Impulsive  insanities,  211,  218 

Indirect,  association,  53  ;  external 
method,  7  ;  subconscious  reactions, 
55;  suggestibility,  10;  suggestion, 
10 

Individual,  evolution  of  the,  183  ;  life 
existence  of  the,  184';  normal,  176 

Inhibitions,  108 

Initial  stages,  n,  19 

Innate  cussedness,  26,  29-31 

Insane,  9,  31 

Insanity,  xi,  xii,  xv,  8,  30,  123,  125, 

174 
Insistent  ideas,  9,  166 
Instability,  199  ;    of  motor  memories, 

198  ;  of  psychopathic  states,  25 
Instincts,  periodic,  211 
Intelligence,  and  motor  psychosis,  195; 

of  the  subconscious,  72,  73 
Intermediary,  levels,  178  ;  links,  182- 

184;    personalities,   178,   182,  184; 

stages,  11,  19  ;  states,  91 
Interrelation,      associative,     21  ;      of 

trance  personalities,  174 
Introspection,  14-16,  18,  21 
Introspective,  accounts,  15-18,  21,  30  ; 

analysis,  15,  20 

Janet,  263 

Joint,  contracted,  259,  260,  276,  277 

Judgments,  13 

Kinsesthesis,  8,  40 


Index 


325 


Kinesthetic,  associations,  202  ;  repre- 
sentations, 197  ;  sensations,  201, 
246,  272,  274,  276  ;  sensibility,  167, 
198,  259 

Kinocentrum,  199 

Kinoplasm,  199 

Lapsed,  mental  states,  122  ;  periods, 
113,  290,  302 

Lapses,  of  consciousness,  268;  of  mem- 
ory, 7 

Law,  biogenetic,  184  ;  biological,  199; 
of  personality  interconnection,  174; 
psycbogenetic,  177  ;  Weber's,  7 

Lepidoptera,  xvii 

Levels,  intermediary,  173  ;  subcon- 
scious, 174,  177  ;  of  waking  life,  177 

Light  experiments,  70,  71 

Life,  animal,  195  ;  existence,  184  ;  ex- 
periences, 183  ;  forms  of,  T95  ; 
history,  22  ;  ideational,  194  ;  ideo- 
motor,  193  ;  mental,  9,  18,  194, 
196  ;  psycho-motor,  10,  12  ;  sensori- 
motor, 194 

Links,  in  association  of  ideas,  196  ; 
intermediary,  183  ;  missing,  182,  1S3 

Localization,  36,  222,  223 

Logarithm  of  stimulus,  7 

Mania,  8 

Maniacal,  40,  1 17 

Manifestations,  functional,  10  ;  men- 
tal, 18  ;  psychomotor,  xi,  x'ii,  xiii, 
xv,  9,  263,  297 

Mass,  of  associated  systems,  211  ;  of 
kinesthetic  memories,  197  ;  of  sen- 
sations, 200  ;  of  systems,  198 

Massiveness,  215 

Mechanism,  physiological,  49 

Medical  treatment,  126 

Medico-legal  standpoint,  122 

Melancholia,  8,  169,  170  ;  course  of, 
176 

Melancholic,  personality,  172,  173, 
206;  state,  171,  205,  206,  219 


Memorization,  7 

Memory,  7,  16,  40,  120,  160,  165,  173, 
175,  182,  197,  201,  202,  210,  226, 
234,  237.  238  ;  epitome  of,  183  ; 
images,  17  ;  loss  of,  105,  106,  115, 
146,  166,  see  Amnesia;  subconscious, 
72,  73,  113,  174,  179.  x93;  synthe- 
sis of,  107 

Mental,  analysis,  14;  diseases,  30,  198; 
facts,  18  ;  groups  and  systems,  217, 
218  ;  life,  4,  iS,  19,  31,  60,  172, 
183,  218  ;  manifestations,  18  ;  ma- 
terial, 165  ;  phenomena,  4  ;  states, 
64,  147,  171,  179,  194,  216 

Metamorphosis,  170,  172,  241  ;  of 
personality,  57 

Metaphysician,  introspection  of  the,  18 

Metaphysics,  27 

Method,  of  automatic  writing,  90  ;  of 
distraction,  66,  74  ;  of  effort  in  hyp- 
noidal  states,  108  ;  of  experimenta- 
tion, 10  ;  external,  6  ;  of  guessing, 
41,  56,  130  ;  of  hypnodization,  xx, 
107,  304,  306,  307,  315  ;  of  im- 
mediate associative  suggestion,  50, 
56  ;  of  intermediary  states,  xv,  91  ; 
internal,  6  ;  of  limitation,  214  ;  of 
mediate  associative  suggestion,  50, 
51;  of  observation,  10;  of  active 
sense  of  personality,  91,  216 ;  of 
substitution,  emotional,  204  ;  of 
synthesis,  91,  93,  154 

Microsomes,  27 

Mimicry,  xvii,  199 

Modifiability,  195,  197 

Modifications,  8,  9,  216 

Moment-consciousness,    xvi,    xvii,  10, 

185 

Motor,  adjustments,  195,  196  ;  ele- 
ments, 194 ;  ideas,  192,  194,  200, 
201  ;  memories,  193,  196-199,  201, 
202,  237,  279  ;  reactions,  194  ;  sug- 
gestions,   193 

Multiple  personality,  107 

Mystical,  30 

Myth,  17 


326 


Index 


Natural  events,  23,  24 

Nature,  24,  53  ;  the  course  of,  23  ;  of 
evidence,  21  ;  of  moods  and  emo- 
tions, 8  ;  mysteries  of,  24  ;  psychic, 
20,  28  ;  of  psychic  epilepsy,  212  ; 
of  psychopathic  anaesthesia,  10  ;  of 
stimuli,  41 

Negative  hallucinations,  43,  51,  56, 
57,  60,  85,  86,  131,  235 

Neoplasm,  200 

Neurofibrils,  27 

Neurology,  xiv,  15 

Neuron,  aggregate,  xi,  xiii,  xv,  212  ; 
degeneration,  x,  xv,  272  ;  disaggre- 
gation, x,  xi,  272  ;  energy,  xiii,  86, 
128,  212,  271  ;  retraction,  10 

Neuropathic,  disturbances,  xi  ;  insani- 
ties, xii ;  psychosis,  xv  ;  state,  xiii 

Neuropathy,  functional,  xii,  xiv; 
necrotic,  xii,  xiv 

Normal,  activity,  21 1  ;  condition,  40, 
91  ;  field  of  vision,  41,  71,  100  ;  in- 
dividual, 176  ;  mental  systems,  164; 
mind,  201  ;  perception;  8  ;  pro- 
cesses, 31  ;  psychic  function,  8  ; 
self,  171;  sleep,  91-93,  98,  214; 
state,  44,  47,  68  ;  stream  of  life, 
61  ;  waking  state,  62,  273 

Objective,  agencies,    140;   bent,    15; 

stimulus,  7 
Objects,    external,    16 ;    subconscious 

perception  of,  41 
Observation,  2, 4, 18, 130;  method  of,  10 
Obsession,  xi,  117 
Occipital,  lobes,   18  ;  pain,   149,   154, 

265  ;  region,  145,  149 
Occiput,  131 

OEdema,  257,  259,  260,  275,  277 
Organic,  amnesia,  116;  character,  10  ; 

evolution,   184 ;    function,   5  ;    life, 

24 ;  whole,  5 
Organism,    adaptation    of    the,    194  ; 

function  of   the,  22  ;    injurious   to 

the,  199 
Organization  of  self,  198 


Organoids,  199 

Organs,  internal,  200  ;  obsessed,  55  ; 

rudimentary,  199 
Orientation,  168 

Pain,  34,  149,  150,  225 

Paradox,  psychopathic,  71 

Parsesthesia,  xviii,  167,  215 

Paralysis,  xviii,  192,  265,  268,  270 

Paranoia,  xii,  8,  30 ;  secondary,  169 

Paraplegia,  264 

Paresis,  general,  8 

Percept,  15,  50 

Perception,  changes  of,  193  ;  falla- 
cious, 30;  subconscious,  51,  73 

Periods,  of  amnesia,  121  ;  of  happi- 
ness, 252  ;  of  high  intellectual  ac- 
tivity, 106 

Personal,  consciousness,  xi,  49,  55,  70. 
71,  73,  108,  148,  153  ;  life,  61 

Personality,  child,  58  ;  double,  107  ; 
intermediary,  178,  182,  184 ;  law 
of,  174;  melancholic  waking,  172; 
metamorphosis  of,  57  ;  subcon- 
scious, 178,  206 ;  suggestion,  81, 
82  ;  trance,  171,  173,  175,  179,  180, 
184,  206  ;  triple,  170 

Phenomena,  of  automatism,  190  ;  bio- 
logical, 4,  199  ;  of  mental  life,  12, 
133;  nature  of,  3  ;  psychic,  13,  15, 
18,  20,  21,  26 

Phylogeny,  184 

Physiological,  functions,  22,  23 ; 
mechanism,  49 

Plasticity  of  the  subconscious,  81,  91 

Pleasant  affective  states,  209,  213 

Pneumographic,  curve,  71  ;  tracings, 
65,  67,  74,  77 

Post-hypnotic,  hallucinations,  186, 
193  ;  states,  107  ;  suggestion,  48, 
77-79,  131,  187,  192,  193 

Power  of  assimilation,  185,  188,  190 

Pressure,  36,  167 

Principle,  of  association  of  ideas,  140  ; 
of  dynamogenesis,  210  ;  of  reduc- 
tion, 4,  10  ;  of  synthesis,  212 


Index 


327 


Process,  of  abbreviation,  181  ;  dis- 
ease, 31;  of  dissociation,  154;  of 
dissolution,  218;  of  elimination,  182; 
evolutionary,  183,  184  ;  of  neuron 
degeneration,  xi  ;  pathological,  x, 
xi,  xii,  xiii  ;  psychic,  9,  31 
Psychiatry,  xiv,  xv 

Psychic,  activity,  106,  196  ;  cases,  11  ; 
constituents,   15  ;  content,  17,  174; 
derangements,  9,   11  ;  elements,   9, 
17;    epilepsy,   149,   152,   199,    212, 
218,  291  ;  facts,  21,  29  ;    function, 
7,  8,  23  ;  life,  8,  23  ;  material,   16, 
314 ;    modifications,    10 ;    neurons, 
156 ;    phenomena,   13,   15,    18,  20, 
21,  26,  28  ;  processes,  9,  31  ;  trau- 
matism, 143 
Psychogenetic  law,  177 
Psychological,  analysis,   15  ;  interpre- 
tation,  17  ;  material,  20  ;  research, 
19  ;  sciences,   18  ;  standpoint,   107, 
185,  188 
Psychology,  14,  18,  159 
Psychomotor,  see  Disturbances  ;    ele- 
ments, 197,  198,  200  ;  equilibrium, 
218  ;    life,    10,    12,    see    Manifesta- 
tions; phenomena,  II,  12;  processes, 
169,  194;  reactions, 55  ;  states,  164 
Psychopathic,   anaesthesia,   10  ;  curve, 
148,  179  ;  cycle,  179  ;  paradox,  71  ; 
phenomena,  12  ;  process,  180,  273  ; 
wave,  148,  178 
Psychopathological,  material,  20  ;  pro- 
cess, 180  ;  research,  xv,  xxi,  19 
Psychopathology,  14,  28,  103,  124,  159 
Psychophysiological,    association    the- 
ory, 15  ;   disaggregation,   xv  ;    phe- 
nomena, 25 
Psychosis,  21,   24  ;  functional,   ix,  x, 
xi,  xii,  xiii,  xiv,  xv,  xviii,   12,   19, 
25.  27,  32,  291  ;  motor,   192  ;  phe- 
nomena of,  23  ;  study  of,  4 

Quasi-personal  unity,  175 
Quotients  of  retention  and  forgetful- 
ness,  7 


Rapport,  81 

Reaction,    14,    55,   195  ;  motor,    166, 

167,  194 
Reassociation,  156 
Recall,  function  of,  7 
Recognition,  74,   107,  no,  in,  174, 

188,  238 
Recollection,  100,  117,  146 
Recurrent  moments,  10 
Redintegration,  219 
Reduction,  principle  of,  4,  10 
Reductive  mass,  211 
Re-emergence  of  subconscious'groups, 

218 
Reflex  activity,  49 
Regeneration,  law  of  organic,  199 
Regions,  subsconscious,  121 
Relaxation,  mental,  304 
Remembering,  function  of,  7 
Repetition,    of    commands,     192  ;    of 

cycles,  180  ;  of  series,  178 
Representations,  200 ;  association  of, 

182  ;  kinsesthetic,  197  ;  motor,  194, 

196,  198  ;  past,  183 
Reproduction,  function'of,  174;  men- 
tal, 107 
Research,  psychological,  14, "21,  116 
Respiration,  76-80 
Restoration,  of  equilibrium,   212  ;    of 

psychomotor  function,  277 
Retention,  subconscious,  83 
Retinal,  anesthesia,  180  ;  areas,  130 
Retraction  of  neuron  systems,  10 
Reversal  of  color  vision,  38 
Reverse  procession  of  affective  states, 

228 
Reversion,  199,  200,  238,  239 
Rhythm,  respiratory,  81,  92 

Second  trance  personality,  173,  177- 

180 
Secondary,   paranoia,    169  ;  percepts, 

9  ;  sensations,  9  ;  sensory  elements, 

182;  state,  146,  147,^149,  151 
Seizures,    convulsive,     34  ;    epileptic, 

212,  297 


328 


Index 


Self,  upper,  108  ;  waking,  171 

Sensation,  8,  15,  16,  18,  20,  200-202, 
215  ;   secondary,  9 

Sensibility,  change  of,  49 ;  general, 
36  ;  kinesthetic,  167  ;  threshold  of, 
6,  68  ;  visual,  8 

Sensitivity,  6 

Sensori-motor,  elements,  194  ;  states, 
194 

Sensory,  aura,  131  ;  elements,  182  ;  re- 
presentations, 192 

Series,  biological,  183  ;  lost  members 
of,  182  ;  past,  183  ;  of  personalities, 
182  ;  of  syllables,  196 

Simulation,  26,  30,  48 

Sleeping  state,  91,  92,  95,  98,  102 

Smelling,  sense  of,  61 

Somnambulism,  xi,  42,  131,  261 

Species,  evolution  of,  183 

Spontaneous  activity,  93 

Stages,  of  abnormal  mental  life,  31  ; 
advanced,  19  ;  initial,  3,  4,  26  ;  of 
science,  27 

States,  abnormal,  153 ;  dissociated, 
90,  95,  138,  153,  154,  206  ;  dream, 
207;  of  euphoria,  170;  hypnotic, 
95.  x53.  2I7  ;  mental,  46,  47,  98, 
121,  147,  148  ;  secondary,  149,  151  ; 
subconscious,  12,  150,  168,  288  ; 
waking, 103, 170,  171,  206,  213,  288 

Static  energy,  86 

Stimuli,  6,  7,  50-52,  62,  85 

Strata,  psychic,  174  ;  second  person- 
ality, 178  ;  subconscious,  179,  180 

Struggle  for  existence,  22,  197 

Subconscious,  examination  of  the,  41  ; 
experience,  53,  60,  66  ;  habit,  76, 
81  ;  intelligence,  72,  73,  76  ;  mem- 
ory, xvi,  xix,  40,  72,  74,  113,  261, 
296  ;  motor  reactions,  40  ;  percep- 
tions, 51;  personality,  177,  178,  182, 
184,  206  ;  reactions,  x,  55  ;  recogni- 
tion, 74;  regions,  73,  75,  121,  137, 
207,  218,  273;  states,  xiv,  12,  150, 
168  ;  systems,  xvi,  xviii,  xix,  50,  52, 
55,  62,  70,  72,  73,  150,  199 


Subconsciousness,  xiv,  60,  71,  77,  107, 
108,  148,  154,  177,  203,  207 

Subject,  active,  197 

Subjective,  account,  19,  20  ;  apprecia- 
tion, 7  ;  experience,  21,  22  ;  meth- 
ods, 20  ;  nature,  20 

Substitution,  method  of,  204,  205 

Suggestibility,  272  ;  abnormal,  10 ; 
normal,  10 

Suggestion,  associative,  50,  51  ;  direct, 
10  ;  of  hallucinations,  43,  47,  186, 
188,  189,  192,  193,  229,  231,  237  ; 
motor,  193  ;  personality,  81,  82,  see 
Post-hypnotic  ;  sensory,  192,  229 

Suicide,  125,  136,  138 

Survival  of  personalities,  182 

Syllables,  "nonsense,"  7,  40 

Sympathetic  system,  200 

Symptoms,  of  aphasia,  1 7  ;  of  fatigue, 
156 ;  of  functional  psychosis,  25, 
102  ;  origin  of,  134 

Synthesis,  of  dissociated  systems,  x, 
xiv,  xv,  xviii,  xix,  xx,  62,  90,  93, 
95,  98,  206,  212,  278,  288,  312  ; 
mental,  14,  299  ;  of  memory,  107 

Systematization,  1S9,  232,  237,  239, 
241,  274,  275 

Systematized,  anaesthesia,  85,  92,  93  ; 
delusion,  14,  30,  160,  166,  169,  171, 
185,  221 

Systems,  dissociated,  x,  xviii,  53-55, 
62,  72,  90,  91,  93,  141,  150,  199, 
211,  212,  275  ;  neuron,  xiv,  10,  156  ; 
subconscious,  xix,  50,  66,  70,  73, 
275  ;  synthetized,  102 

Taste,  sense  of,  167 

Tendency,  to  condensation,  182  ;  to 
dissociation,  141  ;  of  motor  memo- 
ries to  recur,  193,  199  ;  of  recur- 
rence of  subconscious  systems,  113, 
193,  199,  217,  218  ;  to  rhythm,  80,  81 

Tests,  of  case,  41  ;  of  memory,  40  ; 
thermic,  232 

Theory,  of  association,  15  ;  psycho- 
logical, 16. 


Index 


329 


Therapeutic  purposes,  201 

Thermic  sense,  167 

Threshold  of  sensibility,  6,  8,  68,  70 

Touch,  sense  of,  8,  36,  50,  167 ; 
subconscious  hyperesthesia,  68  ; 
threshold,  6 

Tracings,  pneumographic,  65,  67,  71, 
75,  77-81 

Tracts,  habitual,  53 

Trance,  170-172,  177,  180  ;  person- 
ality, 171-173,  175,  180,  181,  206 

Transformation,  172,  185 

Trauma,  261,  263,  272,  273 

Traumatism,  psychic,  143,  145 

Triple  personality,  170 

Types,  of  aphasia,  29  ;  of  triple  per- 
sonality, 175 

Typical  hypochondriacal  melancholia, 
169 


Unconscious,    49,    65,    66,    106,   107, 

293 
Unconsciousness,  xvi,  106,  107,  293 
Unity,  synthetic,  175 
Upper    consciousness,    50,    108,    148, 

154,  304 

Variability  of  systems  of  motor  memo- 
ries, 197 
Variations,  4 

Varieties,  intermediary,  183 
Vision,  8,  78,  167  ;  see  Field  of  vision 
Voluntary  activity,  115,  196 

Waking  personality,  172  ;  see  State 
Waves,  psychopathic,  148,  178 
Weber's  law,  7 
Will,  196,  197 
Wolfe,  7 


PLATE   I 


PLATE  I 

Pneumographs  tracings  in  the  normal  waking  state.  The 
first  tracing  is  under  perfectly  normal  conditions  without  any 
stimulations.  The  second  tracing  shows  the  same  conditions 
with  the  only  difference  that  the  eyes  were  closed  instead  of  being 
open.  The  rest  of  the  tracings  show  the  changes  of  the  normal 
respirations  under  the  influence  of  different  stimuli,  such  as  pleas- 
ant and  unpleasant  odors  and  pricking  sensations. 


\>._v 


Plate  I. 


5«tfL.y9i 


l_\i^>    t\ost& 


QVtxx        WoxmA 


WOYWY 


ywyn&\ 


VVTX/ 


\\«M\    V_V 5tvV3'97 


bie-b    do^>e& 


r^\  H\fN      / 


t^ts  c\.ostA 


tv\K     QVW  \W*\ 


\L\j,«.s  o\>«\ 


I\\e.s  t\ose<i 


hifit    C\o«&       I 


I\y.s  O^W 


I'SYCiiiM'.vriiiiun'.ic.M.  ki:si:ai;iiii:s  in  mhxtai.  ihssi  jciatkin 


PLATE   II 


PLATE  II 

Tracing  taken  in  the  normal  waking  state  and  also  under  the 
influence  of  more  complicated  sensory  stimuli.  It  shows  the  con- 
ditions of  the  patient  under  different  mental  states.  The  first 
part  of  the  curve  in  the  first  tracing  is  perfectly  normai ;  the 
second  part  of  the  first  tracing  shows  the  influence  of  the  gal- 
vanic current;  the  second  tracing,  under  the  influence  of  differ- 
ent painful  stimuli  as  the  faradic  current  and  pricking.  The 
third  tracing  shows  the  influence  of  intense  sound  stimuli.  The 
rest  of  the  tracings  show  the  conditions  of  the  patient  in  different 
mental  states  under  the  influence  of  more  complicated  stimula- 
tions, such,  for  instance,  as  reading  to  her  passages  from  books, 
making  her  do  mental  calculations,  singing  to  her,  or  telling  her 
funny  stories. 


Plate   II. 


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Wb\ym\   &\\.i\ 


C»\.c.\x.\a\\w\       VMv\V(\'\4\\tA        \\4\a\ 


vMron^ 


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l'SYCHI>r.\TIlil].IH'.H.AI.   UKSI  ARCIIKS  1\  M1NTM.    I  USSHCIATION  . 


PLATE   III 


PLATE  III 

The  first  tracing  is  in  the  normal  state  gradually  passing  into 
the  hypnotic  state.  The  rest  of  the  tracings  were  taken  when  the 
patient  was  in  the  hypnotic  state,  stimulations  being  supplied 
either  by  people  who  were  en  rapport  with  her  (designated  by 
-f-  x)  or  by  people  who  did  not  stand  en  rapport  with  her  (desig- 
nated by  —  x).  The  changes  due  to  the  stimulations  by  —  x 
are  perfectly  distinct.  The  different  reactions  here  are  far  more 
emphasized,  showing  that  the  patient  in  the  hypnotic  state  was 
more  sensitive  to  stimulations  given  by  either  +  x  or  —  x  than 
she  was  to  similar  stimulations  in  the  normal  waking  state. 


Plate    III. 


H\mut,     Hv\pwoW^Wow 


S_  ? —         StoWSPl 


\JV  V    \J 


OJ\/     ^^ 


WMt\\   Vi4)\UA  \)\j-x 


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VV  V  V  V 


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0\\    X.IXWO'K    W-5 


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VX\^\X\«,      »\t      <fl  W  \)\J-X  V\\^v-  wkv, 


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V\rt.\X.\tS    sVunSftX^-X 


rSYCMOI'ATHOUH.lCAL  Rl-SKARCIIKS  IN  MENTAL  DISSOCIATION. 


PLATE   IV 


PLATE  IV 

The  first  tracing  shows  the  curve  under  normal  conditions, 
also  the  first  part  of  the  second  tracing  in  which  the  patient 
gradually  passes  through  the  process  of  hypnotization  into  deep 
hypnosis.  The  transition  state  from  the  normal  to  hypnosis  is 
marked,  as  it  is  also  in  the  first  tracing  of  Plate  III.  The  awaken- 
ing of  the  patient  by  counting  is  brought  out  well  in  the  tracing, 
showing  an  abrupt  change.  Experiments  by  the  method  of  dis- 
traction in  the  waking  state  :  the  patient  absorbed  in  reading, 
while  a  sound  stimulus  was  given  a  little  later  by  (+  x).  The 
effects  of  this  stimulus,  which  the  patient  did  not  consciously  per- 
ceive, but  which  she  nevertheless  perceived  subconsciously  and 
to  which  she  accordingly  reacted,  are  indicated  at  the  end  of  the 
second  tracing.  The  rest  of  the  tracings,  3,  4,  5,  and  6, 
are  under  similar  conditions,  the  patient  being  first  put  in  the 
hypnotic  state,  then  awakened,  and  experimented  on  by  the 
method  of  distraction.  Tracings  4  and  5  show  marked  res- 
piratory disturbances  when  the  patient  passed  into  hypnosis  by 
stimulations  of  colored  light  falling  far  outside  her  contracted 
field  of  vision.  Great  hyperesthesia  shown  to  colored  light ;  the 
field  of  colored  vision  is  far  more  extensive  than  that  of  the 
average  normal  individual.  The  different  changes  from  one  state 
to  the  other  and  the  condition  of  the  patient  under  different 
stimuli  when  experimented  on  by  this  method  are  clearly  mani- 
fested in  these  tracings. 


Plate  IV. 


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,    Hvstow,         8\©xi\    sound       (+x)  o   Vast      Y%       \        QxU,  +x  tmu&J 

toff"  I     FaWH     \t*b  ta^n,     I Vl**  W    I  5j 


W\^\Wft.Yi,&\\w\ 


V  V  \l  v  \y  \>'    v    v  \ 


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V    V 1    V    V  V 


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x/^XTn^v^ 


cowitwti,       XiJaJfjwv^, 


ir^^x  r 


,r\r\/r\/^/- 


l'SYCMOl'ATIluI.iic-.lCAI.   RHS1.ARC1U.S  1\  MI-.NTAI.  1  USSOCIATION 


PLATE  V 


PLATE  V 

The  tracings  show  different  reactions  of  the  patient's  subcon- 
sciousness to  different  stimuli  that  were  not  perceived  by  her 
personal  consciousness.  The  first  three  tracings  show  disturb- 
ances when  the  intelligence  of  the  subconscious  is  tested.  The 
patient  is  not  in  hypnosis,  but  under  distraction.  Subconscious 
stimulations  by  whispering,  for  instance,  are  given,  which  the 
patient  does  not  appreciate  consciously.  The  patient  is  to  pass 
into  hypnosis  when  the  stimuli  are  correctly  perceived.  The  in- 
telligence of  the  subconscious  is  tested  by  its  adequate  response 
to  highly  complicated  stimuli  and  by  the  correct  appreciation  of 
them  in  passing  into  the  hypnotic  state  at  the  right  moment, 
when  a  certain  correct  judgment  is  made.  The  subconscious  dis- 
turbances in  the  pneumographic  curve  are  clearly  marked.  The 
subconsciously  formed  habit  of  disturbance  at  multiples  of  five, 
and  of  keeping  pace  with  counting,  is  clearly  brought  out  in  the 
curves. 


Plate  V. 


^>Wv>s\\\o  fc\\  &sYeq> 


Plate  V. 


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to 

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30  IS 


t*^.  C0W\S.'\tv%  Xo  \sii1\e 


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7_5         Covmlms, 


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V  v    V     v      v'     V   V 


*w,  v><2 


ww\   fvwvyw 


l'SYCllOI'ATHOLOGlCAL  RESEARCHES  IN  MENTAL  DISSOCIATION. 


PLATE   VI 


PLATE  VI 

The  patient's  subconscious  reactions  to  rhythmic  stimuli, 
especially  to  counting  or  to  metronome  beats,  stand  out  quite 
distinct.  The  spontaneously  subconsciously  formed  habit  of 
keeping  pace  with  counting  and  beats  and  of  deep  inspirations  at 
multiples  of  five  is  well  marked.  These  deep  inspirations  become 
manifested  when  the  counts  or  beats  are  slow;  when  they  follow 
in  quick  succession  the  deep  inspiration  is  not  marked — seems  to 
disappear,  but  reappears  with  slow  rhythmic.  Counting  and 
sudden  stops  bring  about  corresponding  disturbances  in  the 
pneumographic  curve,  such  as  observed  in  tracings  5  and  7. 
All  these  changes  are  present  alike  in  the  different  rates  of 
rhythm  given  by  +  x  or  —  x. 


Plate   VI. 


Scpt.fc'97 


\       A. 


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vciii.ii'.vriKM.ni'.iu.ii.  rkskakoiks  is  mkntai.  dissociation". 


PLATE  VII 


PLATE  VII 

The  first  tracing  shows  the  state  of  the  patient  in  normal  sleep. 
At  the  very  end  the  same  tracing  shows  the  reaction  of  the  patient 
to  rhythmic  stimuli,  such  as  counting.  No  disturbances  mani- 
fested; rhythm  is  not  followed.  In  the  second  tracing,  in  the  part 
marked  "counted,"  there  is  no  manifestation  of  following  the 
rhythm,  but  there  is  a  recurrence  of  the  deep  respiration  at  "ten." 
The  highly  developed  subconsciously  formed  habit  is  disintegra- 
ting with  the  process  of  synthesis  of  the  dissociated  subconscious 
systems.  The  rest  of  the  tracings  show  the  different  reactions  to 
stimuli  in  normal  sleep  and  respiratory  changes  during  different 
conditions  of  the  sleeping  state. 


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^M\IM\i\ 


I'SVCHOI'ATIIOI.UISICAL  KKSUARCHKS  IN  MENTAL  DISSOCIATION. 


PLATE   VIII 


PLATE  VIII 

The  first  tracing  shows  the  patient  still  in  normal  sleep,  with 
occasional  fits  of  restlessness,  the  patient  becoming  more  and 
more  restless  as  she  neared  the  waking  state.  The  rest  of  the 
tracings  show  the  patient  both  in  the  waking  state  and  in  hypnosis 
and  the  different  reactions  made  during  attempts  at  distraction 
which  utterly  failed.  Rhythm  is  not  followed;  respiratory  dis- 
turbances at  multiples  of  five  in  counting  are  not  present.  The 
subconscious  habit  disappeared  with  the  formed  synthesis  in  the 
normal  sleeping  state. 


Plate  VIII. 


I.V91  \ 


^x\os\s 


Plate  VIII. 


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a\.ee.\i 


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Sw^i,  \.G  \ti.\  \xt\\ 


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\    "Yn^tv  oj»\ 

MMMN) 


PSYCHOPATIIOLOOICAL  RESEARCHES  IN  MENTAL  DISSOCIATION. 


PLATE  IX 


PLATE  IX 

Tracings  by  the  automatograph.  The  patient  in  the  normal 
waking  state  was  asked  to  shut  her  eyes  and  her  hand  was  put 
on  the  automatograph  and  she  was  asked  to  make  a  mental  multi- 
plication of  sixteen  and  twenty-one.  While  she  was  making  this 
calculation,  the  hand  was  making  movements  corresponding  to 
the  ideas  passing  in  her  mind, —  was  writing  down  the  stages  in 
the  process  of  multiplication. 

For  the  other  tracings  she  was  put  in  the  same  position,  and  in 
one  tracing  a  journey  was  described  to  her  and  in  the  other  she 
described  a  journey;  the  hand  automatically  followed  out  the 
description. 


PSYCH0rATIH.ll.OC.ICAI.  KKSKAKCIIKS  IN  MENTAL  MSSOCIATION 


PLATE   X 


PLATE  X 

Shows  automatic  handwriting.  The  patient  in  the  normal 
waking  state  with  her  eyes  shut  was  placed  at  the  automatograph 
and  was  asked  to  describe  an  elephant.  While  she  was  giving 
the  description,  the  hand  was  making  movements  of  writing  cor- 
responding to  the  words  which  she  used  to  describe  the  animal. 
The  same  thing  occurred  when  she  was  asked  to  describe  the 
appearance  of  her  mother.  The  hand  kept  on  making  writing 
movements  of  which  the  patient  was  unconscious. 


I'SYCHOrATHOLUCJCAL  RESEARCHES  IN  MENTAL  DISSOCIATION. 


COLUMBIA   UNIVERSITY 

This  bqgk  is  due  on  the  date  indicated  below,  or  at  the 
expiration  of  a  definite  period  after  the  date  of  borrowing, 
as  provided  by  the  rules  of  the  Library  or  by  special  ar- 
rangement with  the  Librarian  in  charge. 

DATE  BORROWED 

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DATE  BORROWED 

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